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Weight loss and resolution of comorbidities is well established after modern bariatric procedures, however chronology of glyco-lipidic biochemical response is still debated. OBJECTIVE: Aiming to analyze this variable as well as its correlation with food amount and composition, a prospective study was designed. METHODOLOGY: Eighty consecutive patients undergoing Roux-en-Y gastric bypass were investigated every three months until one year after surgery. Females only were accepted and variables included general and nutritional course as well as glucose and lipid measurements. Energy intake was documented including percentage of macronutrients in the diet. RESULTS: Surgery was successful with about 71% excess body weight loss at the end of the first year. Mean energy intake on the 4 postoperative quarters was respectively 519.6 +/- 306.6, 836.0 +/- 407.9, 702.1 +/- 313.1 and 868.8 +/- 342.8 kcal/day (mean +/- SD). Fat intake was initially low but reached 34.1 +/- 7.9% of total calories at final measurement. Blood glucose and lipid fractions tended to be borderline or abnormal preoperatively, and favorably changed by 12 months. Consumption of glucose-and lipid-lowering medication significantly diminished, but each of these was still necessary in 6.3% of the group. Correlation between body mass index and also calorie intake versus glucose and lipid measurements was highly significant (P = 0.000). CONCLUSIONS: 1) Energy intake after operation was very low; 2) Weight loss proceeded rapidly and correlated with meal pattern; 3) Improvement of glucose and lipid tests was adequate but took several quarters to normalize; 4) Decreased requirements for glucose- and lipid-lowering medication was significant but not absolute; 4) Fat percentage of total calories exceeded 30% at the end of the observation period, despite recommendations to the contrary. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate the performance of commercial laying hens fed with different levels of Moringa oleifera leaf meal in their diet. For this purpose, 150 laying hens of the Dekalb White lineage, at 62 weeks of age, and with an initial average weight of 1.458 kg ± 8.70g, were used. They were housed in cages measuring 1.00 X 0.40 X 0.45m, equipped with chute-type feeders, automatic cup-type drinkers and chute for collecting eggs. They were distributed in a completely randomized design, consisting of five treatments with five replications of six birds. The treatments consisted of a reference diet, without moringa inclusion, and four test diets with levels of 1.5%, 3.0%, 4.5% and 6% inclusion of moringa leaf meal. Water was provided ad libitum, and 120 g of feed per bird per day. The total experimental period lasted 122 days. The data obtained were subjected to analysis of variance and Dunnett's test at 5% significance and, when significant, subjected to regression analysis. Analysis of the leaf flour revealed the presence of antinutritional factors in small concentrations. It was observed that the addition of moringa to the birds' diet did not influence performance parameters and provided significant increases in the average egg weight according to moringa inclusion levels of 1.5%, 4.5% and 6% when compared to the control diet, as well as a significant increase in the color of the egg yolks for all levels tested (1.5 to 6%). A reduction in Haugh unit values was observed when inclusion levels of moringa were 4.5% and 6%. Despite a reduction in Haugh unit values, they are still within the classification standards. Analysis of the biochemical parameters of the birds' blood serum did not show significant influences according to the levels of moringa inclusion in the diet, although a numerical reduction was observed in the cholesterol levels of birds fed with an inclusion of 6% of leaf flour in the diet, which could possibly be related to the presence of phytochemical compounds, more precisely β-sitosterol. Moringa oleifera leaf meal can be used to feed laying birds without causing harm to the birds' performance, in addition to intensifying the color of the yolks., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 da Silva Junior et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

In tropical and subtropical climate regions, heat stress is one of the main causes of production losses in laying quails, aggravated by the antinutritional effects of the phytate in diet ingredients, which negatively affect the bioavailability of minerals, especially calcium and phosphorus. This situation results in a reduction in production and the quality of eggs from commercial laying quails. Several nutritional strategies are utilized to reduce the adverse effects of high temperatures and antinutritional factors such as phytate. Among these strategies, the use of exogenous enzymes, such as phytase, stands out as a viable alternative. Phytase breaks down phytate molecules, optimizing the absorption of essential minerals and improving productive performance and egg quality under unfavorable conditions. Specifically, it is recommended to use 1500 FTU of phytase, as it not only reduces the effects of thermal stress but also enhances eggshell thickness and calcium absorption. In this context, this bibliographic review sought to produce a document demonstrating the beneficial effects of the phytase enzyme on the hydrolysis of the phytate molecule, the availability of calcium for Japanese quails ( Coturnix japonica ), and its implications in thermal stress due to heat.

This study aimed to evaluate the nutritive value of three feeds ( Cecropia sp., Pterodon sp., and Inga sp.) for sloths ( Bradypus variegatus ), based on nutritional composition and in vitro gas production. After a 14-day adaptation period to these feeds, approximately 500 g of gastric contents were collected from three female sloths, processed, and incubated with the food samples to evaluate digestibility and in vitro degradation kinetics. Regarding the nutritional composition, the neutral detergent fiber (NDFcp) content was higher with 404 g kg -1 DM ( p = 0.001) in the leaves of Cecropia sp. The non-fibrous carbohydrate contents were greater with 499 g kg -1 DM in Pterodon sp. ( p = 0.002). The greatest cellulose content (211 g kg -1 DM) was found in the leaves of C. pachystachya , as well as the lowest value of 143 g kg -1 DM for hemicellulose. Significant differences in the in vitro digestibility of crude protein ( p = 0.041) were observed, with Inga sp. showing the highest value at 547 g kg -1 DM. In terms of kinetic parameters, Pterodon sp. exhibited higher total gas production (Vt) at 99 mL ( p = 0.023) and digestion rates of fibrous carbohydrates (kdFC) at 0.0223%/h ( p = 0.020) ( p < 0.05). The leaves of Pterodon sp. and Inga sp. showed potential as suitable feeds for B. variegatus , while Cecropia sp. may have negative effects on dry matter intake due to its high NDF content, because of possible repletion effects on the stomach.

This study evaluated the effects of broiler age (A) and levels of replacement (L) of control diet (CD) on the utilization of energy and nutrients of whole corn germ. 720 one-day-old broilers (b) were allocated at completely randomized design to six treatments and six replicates, in three assays: pre-starter (1-8 days, 10 b/cage), starter (15-22 days, 6 b/cage), and grower (28-35 days, 4 b/cage) phases. The treatments were: CD and four test diets (L): 100, 150, 200, 250, or 300 g kg-1 of the CD replaced by WCG levels. The data were adjusted to the response surface model. The stationary points for apparent energy metabolizable (AME) and AME corrected for nitrogen balance (AMEn) were: 4173 and 3591 kcal kg-1, respectively, and coefficients of gross energy (AMCGE), crude protein (AMCCP), dry matter (AMCDM), and ether extract (AMCEE) were: 49.3, 40.4, 72.6, and 61.3%, respectively; and Ileal digestibility coefficient of crude protein (IDCCP), dry matter (IDCDM), digestibility crude protein values (DCP), and digestibility dry matter value (DDM) were: 78.0, 57.96, 8.50, and 56.17%, respectively. The EP for AMEn was at 18 days of age, 28 g kg-1 WCG. There was a correlation between A and L on digestibility and metabolisability of nutrient's WCG.

Objective: Thyroid cancer is rising largely due to greater detection of indolent or slow-growing tumors; we sought to compare the incidence and mortality profiles of thyroid cancer in the State of São Paulo by socioeconomic status (SES)., Methods: Data on thyroid cancer cases diagnosed from 2003 to 2017 in the Barretos Region and from 2001 to 2015 in the municipality of São Paulo were obtained from the respective cancer registries. Corresponding death data were obtained from a Brazilian public government database. Age-standardized rates were calculated and presented as thematic maps. The rates were also calculated by SES and spatial autocorrelation was assessed by global and local indices., Results: There were 419 cases of thyroid cancer and 21 deaths in Barretos, contrasting with the highly populated São Paulo, with 30 489 cases and 673 deaths. The overall incidence rates in São Paulo (15.9) were three times higher than in Barretos (5.7), while incidence rates in women were close to five times higher in Barretos and four times higher in São Paulo than in men. Mortality rates were, in relative terms, very low in both regions. A clear stepwise gradient of increasing thyroid cancer incidence with increasing SES was observed in São Paulo, with rates in very high SES districts four times those of low SES (31.6 vs 8.1). In contrast, the incidence rates in Barretos presented little variation across SES levels., Conclusion: Thyroid cancer incidence varied markedly by SES in São Paulo, with incidence rates rising with increasing socioeconomic index. Overdiagnosis is likely to account for a large proportion of the thyroid cancer burden in the capital., Competing Interests: Disclosure The authors have no multiplicity of interest to disclose., (Copyright © 2023. Published by Elsevier Inc.)

Background: Cancer disparities exist between and within countries; we sought to compare cancer-specific incidence and mortality according to area-level socioeconomic status (SES) in the State of São Paulo, Brazil., Methods: Cancer cases diagnosed 2003-2017 in the Barretos region and 2001-2015 in the municipality of São Paulo were obtained from the respective cancer registries. Corresponding cancer deaths were obtained from a Brazilian public government database. Age-standardized rates for all cancer combined and the six most common cancers were calculated by SES quartiles., Results: There were 14,628 cancer cases and 7513 cancer deaths in Barretos, and 472,712 corresponding cases and 194,705 deaths in São Paulo. A clear SES-cancer gradient was seen in São Paulo, with rates varying from 188.4 to 333.1 in low to high SES areas, respectively. There was a lesser social gradient for mortality, with rates in low to high SES areas ranging from 86.4 to 98.0 in Barretos, and from 99.2 to 100.1 in São Paulo. The magnitude of the incidence rates rose markedly with increasing SES in São Paulo city for colorectal, lung, female breast, and prostate cancer. Conversely, both cervical cancer incidence and mortality rose with lower levels of SES in both regions., Conclusions: A clear SES association was seen for cancers of the prostate, female breast, colorectum, and lung for São Paulo. This study offers a better understanding of the cancer incidence and mortality profile according to SES within a highly populated Brazilian state., (© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)

Purpose: Studying breast and cervical cancers in space and time and verifying divergences of different territorially established socioeconomic profiles., Methods: Ecological study using spatial scanning (with socioeconomic characterization), space-time, and spatial variation of temporal trends, in order to identify significant clusters of high- and low-risk or temporal trends, of deaths from breast cancer and cervical cancer, in the city of São Paulo, Brazil, during 2000-2016., Results: High-risk spatial clusters were identified in the central areas, and low-risk clusters were identified in the peripheral areas, which were associated with better and worse socioeconomic conditions, respectively. As for cervical cancer, the pattern was the opposite. High-risk space-time clusters occurred in the early years of the study, whereas low-risk clusters occurred in the most recent years. For breast cancer, the central areas showed a temporal trend of decreasing mortality and the peripheral areas showed an increasing trend. While for cervical cancer, in general, the temporal trend was for the identified clusters to fall., Conclusions: It is expected that this study will provide insights for the formulation of public policies to implement prevention and control measures, in order to reduce mortality and inequalities related to breast and cervical cancers., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Objective: To identify spatial variability of mortality from breast and cervical cancer and to assess factors associated in the city of São Paulo., Methods: Between 2009 and 2016, 10,124 deaths from breast cancer and 2,116 deaths from cervical cancer were recorded in the Mortality Information System among women aged 20 years and over. The records were geocoded by address of residence and grouped according to Primary Health Care coverage areas. A spatial regression modeling was put together using the Bayesian approach with a Besag-York-Mollié structure to verify the association of deaths with selected indicators., Results: Mortality rates from these types of cancer showed inverse spatial patterns. These variables were associated with breast cancer mortality: travel time between one and two hours to work (RR - relative risk: 0.97; 95%CI - credible interval: 0.93-1.00); women being the head of the household (RR 0.97; 95%CI 0.94-0.99) and deaths from breast cancer in private health institutions (RR 1.04; 95%CI 1.00-1.07). The following variables were associated with mortality from cervical cancer: travel time to work between half an hour and one hour (RR 0.92; 95%CI 0.87-0.98); per capita household income of up to 3 minimum wages (RR 1.27; 95%CI 1.18-1.37) and ratio of children under one year of age related to the female population aged 15 to 49 years (RR 1.09; 95%CI 1.01-1.18)., Conclusion: The predicted RR for mortality from these cancers were calculated and associated with the socioeconomic conditions of the areas covered.

Background: The "Syphilis No!" campaign the Brazilian Ministry of Health (MoH) launched between November 2018 and March 2019, brought forward the concept "Test, Treat and Cure" to remind the population of the importance of syphilis prevention. In this context, this study aims to analyze the similarity of syphilis online news to comprehend how public health communication interventions influence media coverage of the syphilis issue., Methods: This paper presented a computational approach to assess the effectiveness of communication actions on a public health problem. Data were collected between January 2015 and December 2019 and processed using the Hermes ecosystem, which utilizes text mining and machine learning algorithms to cluster similar content., Results: Hermes identified 1049 google-indexed web pages containing the term 'syphilis' in Brazil. Of these, 619 were categorized as news stories. In total, 157 were grouped into clusters of at least two similar news items and a single cluster with 462 news classified as "single" for not featuring similar news items. From these, 19 clusters were identified in the pre-campaign period, 23 during the campaign, and 115 in the post-campaign., Conclusions: The findings presented in this study show that the volume of syphilis-related news reports has increased in recent years and gained popularity after the SNP started, having been boosted during the campaign and escalating even after its completion.

This study analyzes online news disseminated throughout the pre-, during-, and post-intervention periods of the "Syphilis No!" Project, which was developed in Brazil between November 2018 and March 2019. We investigated the influence of sentiment aspects of news to explore their possible relationships with syphilis testing data in response to the syphilis epidemic in Brazil. A dictionary-based technique (VADER) was chosen to perform sentiment analysis considering the Brazilian Portuguese language. Finally, the data collected were used in statistical tests to obtain other indicators, such as correlation and distribution analysis. Of the 627 news items, 198 (31.58%) were classified as a sentiment of security (TP2; stands for the news type 2), whereas 429 (68.42%) were classified as sentiments that instilled vulnerability (TP3; stands for the news type 3). The correlation between the number of syphilis tests and the number of news types TP2 and TP3 was verified from (i) 2015 to 2017 and (ii) 2018 to 2019. For the TP2 type news, in all periods, the p -values were greater than 0.05, thus generating inconclusive results. From 2015 to 2017, there was an ρ = 0.33 correlation between TP3 news and testing data ( p -value = 0.04); the years 2018 and 2019 presented a ρ = 0.67 correlation between TP3 news and the number of syphilis tests performed per month, with p -value = 0.0003. In addition, Granger's test was performed between TP3 news and syphilis testing, which resulted in a p -value = 0.002, thus indicating the existence of Granger causality between these time series. By applying natural language processing to sentiment and informational content analysis of public health campaigns, it was found that the most substantial increase in testing was strongly related to attitude-inducing content (TP3).

Background: This study examined the spatial pattern of the colorectal cancer (CRC) in the 18 municipalities that compose the Regional Health Department of Barretos (RHD-V), which is in the northeast of the state of São Paulo, Brazil., Methods: All incident cases and deaths from CRC between 2002 and 2016 were included. Age-standardized rates (ASR) for incidence and mortality per 100,000 person-years were used to evaluate the spatial distribution for the total and five-year periods. The lethality rates were also assessed. Excess risk maps compared the observed and expected events. Age-standardized net survival was used to evaluate CRC survival., Results: For CRC incidence, the ASR value for the general population over the entire period (2002-2016) was 17.7 (95% CI: 16.7, 18.6), ranging from 16.7 (95% CI: 14.9, 18.4) (2002-2006) to 20.0 (95% CI: 18.3, 21.7) (2012-2016) per 100,000. When males and females were compared, the ASR was 20.1 (95% CI: 18.6, 21.6) and 15.7 (95% CI: 14.5, 17.0) per 100,000, respectively. For CRC mortality (2002-2016), the ASR was 8.2 (95% CI: 7.6, 8.9), ranging from 9.0 (95% CI: 7.8, 10.3) (2002-2006) to 8.2 (95% CI: 7.2, 9.3) (2012-2016) per 100,000. Overall, the excess risk up to 2.0 was more frequent. In terms of survival, municipalities with large port populations had lower survival in comparison with medium port., Conclusions: This study showed a variation in CRC incidence and mortality, with differences considering five-year periods and gender, being the incidence higher in males than females in the entire period, with mortality equivalent to half the incidence. The survival was lower in municipalities with large port populations in comparison with medium port. Knowing spatial patterns of incidence, mortality, lethality, and survival can be necessary to support policymakers to advance or implement effective cancer control programs., Competing Interests: 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., (© 2022 The Authors.)

Despite the developments in cancer research over years, cancer is still one of the leading causes of death worldwide. In Brazil, the number of cancer cases for the several next years (2020-2022) is expected to increase up to 625,000. Thus, translational research has been vital to determine the potential risk, prognostic, and predictive biomarkers in cancer. Therefore, Barretos Cancer Hospital implemented a biobank (BB-BCH) in 2006, which is responsible for processing, storage, and provision of biological materials from cancer and non-cancer participants. Hence, this article aimed to describe BB-BCH's history, experiences, and outcomes and explore its impact on Brazilian translational oncology research scenario. BB-BCH has a multidisciplinary team who are responsible for guaranteeing the quality of all processes as recommended by international guidelines for biobanks. Furthermore, BB-BCH has ample equipment to ensure the quality of all material requested by researchers as genetic material (DNA and RNA) and/or entire biospecimens. From 2006 to 2019, BB-BCH contained 252,069 samples from 44,933 participants, the whole collection is represented by 15 different types of biospecimens collected from them. According to our data, the most collected and stored topography in men is head and neck (29%); in women is breast (28%); and in children is torso and limb (27%) samples. Finally, we supported national and international consortia and projects such as The Cancer Genome Atlas. BB-BCH is a vital knowledge source for scientific community, enabling the development of high-quality studies, with a wide variety of tumor categories and high national representativeness of Brazilian population., (© 2021. The Author(s), under exclusive licence to Springer Nature B.V.)

Most leaf functional trait studies in the Amazon basin do not consider ontogenetic variations (leaf age), which may influence ecosystem productivity throughout the year. When leaf age is taken into account, it is generally considered discontinuous, and leaves are classified into age categories based on qualitative observations. Here, we quantified age-dependent changes in leaf functional traits such as the maximum carboxylation rate of ribulose-1,5-biphosphate carboxylase/oxygenase (Rubisco) (Vcmax), stomatal control (Cgs%), leaf dry mass per area and leaf macronutrient concentrations for nine naturally growing Amazon tropical trees with variable phenological strategies. Leaf ages were assessed by monthly censuses of branch-level leaf demography; we also performed leaf trait measurements accounting for leaf chronological age based on days elapsed since the first inclusion in the leaf demography, not predetermined age classes. At the tree community scale, a nonlinear relationship between Vcmax and leaf age existed: young, developing leaves showed the lowest mean photosynthetic capacity, increasing to a maximum at 45 days and then decreasing gradually with age in both continuous and categorical age group analyses. Maturation times among species and phenological habits differed substantially, from 8 ± 30 to 238 ± 30 days, and the rate of decline of Vcmax varied from -0.003 to -0.065 μmol CO2 m-2 s-1 day-1. Stomatal control increased significantly in young leaves but remained constant after peaking. Mass-based phosphorus and potassium concentrations displayed negative relationships with leaf age, whereas nitrogen did not vary temporally. Differences in life strategies, leaf nutrient concentrations and phenological types, not the leaf age effect alone, may thus be important factors for understanding observed photosynthesis seasonality in Amazonian forests. Furthermore, assigning leaf age categories in diverse tree communities may not be the recommended method for studying carbon uptake seasonality in the Amazon, since the relationship between Vcmax and leaf age could not be confirmed for all trees., (© The Author(s) 2021. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: To perform a bibliometric analysis of studies that evaluated the barriers to access to cancer palliative care (PC)., Methods: This was a bibliometric review using MEDLINE; EMBASE; Web Of Science; LILACS and the Cochrane Library. A search was conducted with the terms Barriers, Palliative Care and Cancer. Articles whose objectives targeted barriers to access to PC were considered, regardless of the year of publication. The setting is articles published from 1987 to 2020., Results: A total of 6158 articles were identified, of which 217 were eligible for analysis. The USA and UK being the countries with the largest number of articles on the subject (n=101, n=18, respectively). After expert analysis, the barriers were grouped into nine categories., Conclusions: Barriers related to symptom control were identified in 19% of the eligible articles, along with barriers related to health, which with 24% of occurrence in the articles, were the most frequently cited barriers. Countries which have implemented PC for some time were those with the greatest number of publications and in journals with the highest impact factors. Cross-sectional study design continues to be the most frequently used in publications., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

Breast cancer is the most frequently diagnosed type of cancer and is the leading cause of death from cancer in the female population. Screening mammograms and early treatment are the most frequently used means to attempt to reduce this mortality and are promoted during Pink October, an annual awareness-raising campaign. However, recent studies have correlated the increase in screening with higher morbidity and mortality, due to overdiagnosis and overtreatment. The current study assessed searches related to breast cancer and mammogram in Google Trends from 2004 to 2019 in terms of trend, seasonality, and distribution in Brazilian states. The study also evaluatedH the correlation between the number of searches in Google Trends and the number of screening mammograms. The two series showed a seasonal pattern with peaks in October, and there was an excess in tests performed outside the recommended age bracket. Pink October transmitted and popularized health information and induced behaviors related to this information, which are three desirable aspects in health communication and education. However, the campaign also generated an excess in screening mammograms and did not encourage autonomy and free and informed consent. Pink October revealed both the potential of mass communication in health and the need for messages to be aligned with the best available scientific evidence.

Background: Noise pollution is increasingly recognised as a public health hazard, yet limited evidence is available from low- and middle-income countries (LMIC), particularly for specific sources. Here, we investigated the association between day-night average (L dn ) aircraft noise and the risk of death due to cardiovascular disease (CVD), stroke and coronary heart disease (CHD) at small-area level around São Paulo's Congonhas airport, Brazil during the period 2011-2016., Methods: We selected 3259 census tracts across 16 districts partially or entirely exposed to ≥50 dB aircraft noise levels around the Congonhas airport, using pre-modelled 5 dB L dn noise  bands (≤50 dB to > 65 dB). We estimated the average noise exposure per census tract using area-weighting. Age, sex and calendar year-specific death counts for CVD, stroke and CHD were calculated by census tract, according to the residential address at time of death. We fitted Poisson regression models to quantify the risk associated with aircraft noise exposure, adjusting for age, sex, calendar year and area-level covariates including socioeconomic development, ethnicity, smoking and road traffic related noise and air pollution., Results: After accounting for all covariates, areas exposed to the highest levels of noise (> 65 dB) showed a relative risk (RR) for CVD and CHD of 1.06 (95% CI: 0.94; 1.20) and 1.11 (95%CI: 0.96; 1.27), respectively, compared to those exposed to reference noise levels (≤50 dB). The RR for stroke ranged between 1.05 (95%CI: 0.95;1.16) and 0.91 (95%CI: 0.78;1.11) for all the noise levels assessed. We found a statistically significant positive trend for CVD and CHD mortality risk with increasing levels of noise (p = 0.043 and p = 0.005, respectively). No significant linear trend was found for stroke. Risk estimates were generally higher after excluding road traffic density, suggesting that road traffic air and noise pollution are potentially important confounders., Conclusions: This study provides some evidence that aircraft noise is associated with increased risk of CVD and CHD mortality in a middle-income setting. More research is needed to validate these results in other LMIC settings and to further explore the influence of residual confounding and ecological bias. Remarkably, 60% of the study population living near the Congonhas airport (~ 1.5 million) were exposed to aircraft noise levels > 50 dB, well above those recommended by the WHO (45 dB), highlighting the need for public health interventions.

Background: The aim of this study was to estimate the prevalence of alcohol and tobacco experimentation by adolescents and to verify the association between cell phone use with alcohol and tobacco consumption in adolescents with different physical activity levels., Methods: This work is a cross-sectional study with a representative sample of 772 adolescents (52.6% girls; age: 16.63±0.70 years old). Self-reported questionnaires were assessed to verify the cell phone use, physical activity level, alcohol and tobacco consumption. Logistic regressions tested the associations obtaining odds ratios with 95% confidence intervals., Results: Alcohol and tobacco consumption prevalence reached 43.4% and 7.8% of adolescents, respectively. Insufficiently active adolescents who reported using cell phones more than and 2 hours a day were more likely to use alcohol (OR: 1.58; 95% CI: 1.14 - 2.19) and tobacco (OR: 2.46; 95% CI: 1.23 - 4.96)., Conclusions: We found a high prevalence of cell phone use and a worrying prevalence of alcohol and tobacco consumption by adolescents. The use of the cell phone for more than two hours a day seemed to be a risk factor for alcohol and tobacco consumption in insufficiently active adolescents.

Background: Despite widespread evidence that air pollution is carcinogenic, there is little evidence from low-middle income countries, especially related to childhood malignancies. We examined the role of traffic related pollution on lymphohematopoietic malignancies among under-14 s in Sao Paulo., Methods: All incident cases between 2002 and 2011 were collected from a population-based registry. Exposures were assigned on residential address at diagnosis via traffic density database (for the year 2008) and a satellite derived NO 2 land use regression model (averaged between 1997 and 2011). Incidence rate ratios (IRRs) were calculated via Poisson Regression adjusted by age, gender and socioeconomic status (SES), with additional stratification by SES., Results: A positive association between traffic and NO 2 with some lymphohematopoietic malignancies was observed with the degree of effect differing by SES. For example, lymphoid leukemia IRRs in the lower SES group were 1.21 (95 % CI: 1.06, 1.39) for traffic density and 1.38 (95 % CI: 1.13, 1.68) for NO 2 . In the higher group they were 1.06 (95 % CI: 1.00, 1.14) and 1.37 (95 % CI: 1.16, 1.62)., Conclusion: NO 2 and traffic density were associated with Hodgkin lymphoma and lymphoid leukemia among children in São Paulo. Differing IRRs by gender and SES group indicate differences in underlying risk and/or exposure profiles., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background: Alongside the SARS-CoV-2 (COVID-19) pandemic, Brazil also faces an ongoing rise in cancer burden. In 2020, there were approximately 592 000 new cancer cases and 260 000 cancer deaths. Considering the heterogeneities across Brazil, this study aimed to estimate the impact of the COVID-19 pandemic on cancer-related hospital admissions at a national and regional level., Methods: The national, regional, and state-specific monthly average of cancer-related hospital admission rates per 100 000 inhabitants and 95% confidence intervals (95% CIs) were calculated from March to July (2019: pre-COVID-19; and 2020: COVID-19 period). Thematic maps were constructed to compare the rates between periods and regions., Results: Cancer-related hospital admissions were reduced by 26% and 28% for clinical and surgical purposes, respectively. In Brazil, the average hospitalization rates decreased from 13.9 in 2019 to 10.2 in 2020 per 100,000 inhabitants, representing a rate difference of -3.7 (per 100,000 inhabitants; 95% CI: -3.9 to -3.5) for cancer-related (clinical) hospital admissions. Surgical hospital admissions showed a rate decline of -5.8 per 100,000 (95% CI: -6.0 to -5.5). The reduction in cancer-related admissions for the surgical procedure varies across regions ranging between -2.2 and -10.8 per 100 000 inhabitants, with the most significant decrease observed in the south and southeastern Brazil., Conclusions: We observed a substantial decrease in cancer-related hospital admissions during the COVID-19 pandemic with marked differences across regions. Delays in treatment may negatively impact cancer survival in the future; hence, cancer control strategies to mitigate the impact are needed.

Contamination of primary and cell cultures by mycoplasmas is one of the main economic and biological pitfalls in basic research, diagnosis and manufacture of biotechnological products. It is a common issue which may be difficult to conduct surveillance on. Mycoplasma presence may affect several physiological parameters of the cell, besides being considered an important source of inaccurate and/or non-reproducible scientific results. Each cell type presents characteristical symptoms, mainly morphological, that indicate a contamination by mycoplasma. HEp-2 cells originate from carcinoma of the larynx and are, therefore, part of the respiratory tract, which is one of mycoplasma habitats. Despite the importance these cells in several biological research (evaluation of cell proliferation and migration, apoptosis, antiviral and antitumor compounds), the alterations induced by mycoplasma contamination in HEp-2 cells have not yet been described. Here, we describe the progressive morphological alterations in culture of HEp-2 cells infected with mycoplasma, as well as the-diagnosis of the infection and its treatment. Mycoplasma contamination described within this work led to cytoplasm elongation, cell-to-cell spacing, thin plasma membrane projections, cytoplasmic vacuoles, fusion with neighboring cells, and, finally, cell death. Contamination was detected by fluorescence imaging (DAPI) and PCR reactions. The cultures were treated with BM-Cyclin antibiotic to eliminate contamination. The data presented here will be of relevance to researchers whose investigations involve cell culture, especially respiratory and HEp-2 cells.

Objective: To verify the spatial pattern of mortality from breast and cervical cancer in areas of primary health care, considering socioeconomic conditions., Methods: This is an ecological study, from January 2000 to December 2016. The study area is the municipality of São Paulo, Brazil, and its 456 coverage areas of primary health units. Information on deaths of women aged 20 years or over were geocoded according to residence address. We calculated mortality rates, standardized by age, and smoothed by the local empirical Bayesian method, and grouped into three or two years to reduce the random fluctuation of the data. In addition, bivariate global and local Moran indexes were calculated to verify the existence of spatial agglomeration of standardized mortality rates with a domain of socioeconomic condition, elaborated based on the Índice Paulista de Vulnerabilidade Social (IPVS - São Paulo Index of Social Vulnerability)., Results: The success rate of geocoding was 98.9%. Mortality from breast cancer, without stratification by time, showed a pattern with higher rates located in central regions with better socioeconomic conditions. It showed a decrease at the end of the period and a change in spatial pattern, with increased mortality in peripheral regions. On the other hand, mortality from cervical cancer remained with the highest rates in peripheral regions with worse socioeconomic conditions, despite being reduced over time., Conclusion: The spatial pattern of mortality from the studied cancers, over time, suggests association with the best socioeconomic conditions of the municipality, either as protection (cervical) or risk (breast). This knowledge may direct resources to prevent and promote health in the territories.

Urgent treatments, in any modality, to fight SARS-CoV-2 infections are desired by society in general, by health professionals, by Estate-leaders and, mainly, by the scientific community, because one thing is certain amidst the numerous uncertainties regarding COVID-19: knowledge is the means to discover or to produce an effective treatment against this global disease. Scientists from several areas in the world are still committed to this mission, as shown by the accelerated scientific production in the first half of 2020 with over 25,000 published articles related to the new coronavirus. Three great lines of publications related to COVID-19 were identified for building this article: The first refers to knowledge production concerning the virus and pathophysiology of COVID-19; the second regards efforts to produce vaccines against SARS-CoV-2 at a speed without precedent in the history of science; the third comprehends the attempts to find a marketed drug that can be used to treat COVID-19 by drug repurposing. In this review, the drugs that have been repurposed so far are grouped according to their chemical class. Their structures will be presented to provide better understanding of their structural similarities and possible correlations with mechanisms of actions. This can help identifying anti-SARS-CoV-2 promising therapeutic agents., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Traffic-related air pollution is being associated with hematologic cancer in young individuals. This study performed a spatial analysis of the hematologic cancer incidence and mortality among younger people, using a Bayesian approach, to associate with traffic density in the city of São Paulo, Brazil. Two databases were employed: incidence (2002-2011) and mortality (2002-2013). The relationships between the cases of hematologic cancer and the covariates - traffic density, the Municipal Human Development Index (MHDI), and population density - were evaluated using a Besag-York-Mollié ecological model with relative risks (RRs) estimates. Per 1-unit standard-deviation increase in traffic density, in the MHDI, and in population density, the RR for the incidence was 1.06 (95% CI: 0.97-1.14), 1.28 (95% CI: 1.16-1.42), and 1.01 (95% CI: 0.94-1.08), respectively. For mortality, no covariates were considered risk factors. Our findings suggest significant association between living in regions with better socioeconomic conditions, where traffic density is usually higher, and risk of hematologic cancer in younger people.

Lipid abnormalities and subclinical systemic inflammation are associated with atherosclerosis and are used as markers of cardiovascular risk. Studies have suggested a possible beneficial effect of dairy products on cardiovascular health, but the results in lipid and inflammatory markers are still controversial. This study aimed to assess the association between consumption of dairy products and their different subgroups and C-reactive protein (CRP), LDL-cholesterol (LDL-C), and triglyceride/HDL-cholesterol ratio (TG/HDL-C) in participants in the Longitudinal Study of Adult Health (ELSA-Brasil) (n = 9,372). Consumption of dairy products was assessed via a validated food frequency questionnaire and expressed as servings/day. Total consumption of dairy products was described in four categories (≤ 1 serving/day to > 4 servings/day). The associations were estimated via odds ratios (OR), using the group with the lowest consumption (≤ 1 serving/day) as the reference. The lowest ORs for TG/HDL-C in the multivariate model (0.70; 95%CI: 0.55-0.90 in men; and 0.55; 95%CI: 0.43-0.70 in women) were found in the group that consumed > 4 servings day of dairy products. These results were supported by the inverse associations between different subgroups of dairy products and the TG/HDL-C ratio. No association was found between consumption of dairy products and their subgroups and LDL-C and CRP. The results suggest a possible beneficial effect of dairy products on lipid profile, but longitudinal and intervention studies are needed to elucidate the effect mechanisms of different types of dairy products.

Twelve 2-(quinolin-4-ylmethylene) hydrazinecarbothioamide derivatives were synthetized and their biological properties were investigated, among which, the ability to interact with DNA and BSA through UV-Vis absorption, fluorescence, Circular Dichroism, molecular docking and relative viscosity, antiproliferative activity against MCF-7 and T-47D mammary tumor cells and RAW-264.7 macrophages and inhibitory capacity of the enzyme topoisomerase IIα. In the binding study with DNA and BSA, all the compounds displayed affinity for interaction with both biomolecules, especially JF-92 (p-ethyl-substituted), with binding constant of 1.62 × 10 6 and 1.43 × 10 5 , respectively, and DNA binding mode by intercalation. The IC 50 values were obtained between 0.81 and 1.48 μM and topoisomerase inhibition results in 10 μM. Thus, we conclude that the reduction of the acridine to quinoline ring did not disrupt the antitumor action and that substitution patterns are important for biomolecule interaction affinity as they demonstrate the potential of these compounds for anticancer therapy., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

In the present study, acridine-thiosemicarbazones (ATD) derivatives were tested for their interaction properties with BSA through UV-Vis absorption and fluorescence spectroscopic studies. Both hyperchromic and hypochromic effects, as well as red or blue shifts were demonstrated after the derivatives were added to the BSA. Values for the binding constant (K b ) ranged from 1.62 × 10 4 to 8.71 × 10 5  M -1 and quenching constant (K SV ) from 3.46 × 10 2 to 7.83 × 10 3  M -1 indicating a good affinity to BSA protein. Complementary, two compounds were selected to assess their inhibition activity against topoisomerase IIα enzyme, of which derivative 3a presented the best result. Moreover, to evaluate protein-ligand interactions, as well as the antitopoisomerase potential of these compounds, tests of molecular modeling were performed between all compounds using the albumin and Topoisomerase IIα/DNA complex. Finally, in silico studies showed that all derivatives used in this research displayed good oral bioavailability potential., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background: Multiple lines of evidence have associated exposure to ambient air pollution with an increased risk of respiratory malignancies. However, there is a dearth of evidence from low-middle income countries, including those within South America, where the social inequalities are more marked., Objectives: To quantify the association between exposures to traffic related air pollution and respiratory cancer incidence and mortality within São Paulo, Brazil. Further, we aim to investigate the role of socioeconomic status (SES) upon these outcomes., Methods: Cancer incidence between 2002 and 2011 was derived from the population-based cancer registry. Mortality data (between 2002 and 2013) was derived from the Municipal Health Department. A traffic density database and an annual nitrogen dioxide (NO 2 ) land use regression model were used as markers of exposure. Age-adjusted Binomial Negative Regression models were developed, stratifying by SES and gender., Results: We observed an increased rate of respiratory cancer incidence and mortality in association with increased traffic density and NO 2 concentrations, which was higher among those regions with the lowest SES. For cancer mortality and traffic exposure, those in the most deprived region, had an incidence rate ratio (IRR) of 2.19 (95% CI: 1.70, 2.82) when comparing the highest exposure centile (top 90%) to the lowest (lowest 25%). By contrast, in the least deprived area, the IRR for the same exposure contrast was.1.07 (95% CI: 0.95, 1.20). For NO 2 in the most deprived regions, the IRR for cancer mortality in the highest exposed group was 1.44 (95% CI: 1.10, 1.88) while in the least deprived area, the IRR for the highest exposed group was 1.11 (95% CI: 1.01, 1.23)., Conclusions: Traffic density and NO 2 were associated with an increased rate of respiratory cancer incidence and mortality in São Paulo. Residents from poor regions may suffer more from the impact of traffic air pollution., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Pollution related to traffic is a major problem in urban centers and a large portion of the population is vulnerable to its health effects. This study sought to identify a potential association between hospital admissions due to respiratory tract cancer and vehicular traffic density in the city of São Paulo, Brazil. It is an ecological study of the public (Hospital Inpatient Authorization - AIH, in Portuguese) and private (Hospital Inpatient Communication - CIH, in Portuguese) health care systems, from 2004 to 2006, geocoded by individuals' residential addresses. Using a Besag-York-Mollié ecological model, we initially evaluated the relationship between number of cases of hospital admission due to respiratory tract cancer in each weighting area and the standardized co-variables: traffic density and Municipal Human Development Index (MHDI) as indicator of socioeconomic status. Using a classic Poisson model, we then evaluated the risk associated with growing traffic density categories. The Besag-York-Mollié model estimated a RR = 1.09 (95%CI: 1.02-1.15) and RR = 1.19 (95%CI: 1.10-1.29) of admission due to respiratory tract cancer for each increase of one standard deviation of traffic and MHDI, respectively. The Poisson model also showed a clear exposure-response gradient for admission due to respiratory tract cancer (IRR = 1.11; 95%CI: 1.07-1.15, for each 10 units of added traffic density). This study suggests that there is an association between residing in areas with high traffic density and hospital admissions due to respiratory tract cancer in the city of São Paulo.

Nine new spiroacridine derivatives were synthetized by introducing cyano-N-acylhydrazone group between the acridine and phenyl-substituted rings followed by spontaneous cyclization. The new compounds were assayed for their DNA binding properties, human topoisomerase IIα inhibition and bovine serum albumin (BSA) interaction. Besides, docking analysis were performed in order to better understanding the biomolecule-compounds interactions. All compounds interacted with BSA which was demonstrated by the fluorescence suppression constant of 10 4  M -1 . Compounds with chloro and NO 2 substituents at that para-position on phenyl ring demonstrated the best results for BSA interaction. DNA binding constant determined by UV-vis data demonstrated high values for AMTAC-11 and AMTAC-14, 1.1 × 10 8  M -1 and 4.8 × 10 6  M -1 , respectively, and all others presented constant values of 10 5  M -1 . AMTAC-06 with chloro at para-position on phenyl ring presented a topoisomerase II inhibition of 84.34% in comparison to the positive controls used. Docking studies indicated that AMTAC-06 is able to intercalate the DNA base pairs at topoisomerase IIα active site, preventing DNA connection after break, in a process known as poisoning. Topoisomerase enzyme inhibition result was correlated to BSA interaction profile, since AMTAC-06 showed the best results in both analysis. The findings obtained here proved that methoxy or chloro substitution on phenyl ring at para-position is fundamental for in vitro activity of new spiroacridine derivatives, and indicates that AMTAC-06 is a promising entity and should serve as a lead compound in the development of new DNA and protein binders, as well as human topoisomerase II inhibitors., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background: There is evidence that exposure to traffic-related air pollution is related to the incidence of and mortality associated with lung cancer. The aim of this study was to perform a spatial analysis, with a Bayesian approach, to test the hypothesis that high traffic density is associated with increased respiratory tract cancer incidence and mortality risk among individuals over 20 years of age residing in the city of São Paulo, Brazil., Methods: We employed data from two different databases: the São Paulo Municipal Population-Based Cancer Registry (2002-2011 cancer incidence data); and the Mortality Database of the São Paulo Municipal Health Department (2002-2013 cancer mortality data). The relationships between the number of cases of respiratory tract cancer in each area analyzed and the standardized covariates-traffic density and the Municipal Human Development Index (MHDI)-were evaluated with a Besag-York-Mollié ecological model with relative risks (RRs) estimates., Results: Per 1-unit standard-deviation increase in traffic density and in the MHDI, the RR for respiratory tract cancer incidence was 1.07 (95% CI: 1.02-1.13) and 1.25 (95% CI: 1.18-1.32), respectively, whereas the RR for mortality was 1.04 (95% CI: 0.99-1.09) and 1.23 (95% CI: 1.16-1.30), respectively., Conclusion: Our findings support the hypothesis that residing in areas with high traffic density is associated with increased respiratory tract cancer incidence and mortality risk in the city of São Paulo., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Objectives: We assessed sociodemographic and health care factors of mothers and newborns during a 2015-2016 outbreak of microcephaly in Recife, Brazil, and we analyzed the spatial distribution and incidence risk of newborns with microcephaly in relation to socio-environmental indicators., Methods: We collected data from August 2015 through May 2016 from Brazil's Live Birth Information System and Bulletin of Microcephaly Notification, and we geocoded the data by maternal residence. We constructed thematic maps of districts, according to socio-environmental and vector indicators. We identified spatial aggregates of newborns with microcephaly by using the Bernoulli model. We performed logistic regression analyses to compare the incidence risk of microcephaly within socio-environmental indicator groups., Results: We geocoded 17 990 of 19 554 (92.0%) live births in Recife, of which 202 (1.1%) newborns were classified as having microcephaly, based on a head circumference of ≥2 standard deviations below the mean. Larger proportions of newborns with microcephaly (compared with newborns without microcephaly) were born to mothers who delivered in a public hospital, did not attend college, were aged ≤19, or were black or mixed race. A higher risk of microcephaly (incidence rate ratio [IRR] = 3.90; 95% confidence interval [CI], 1.88-8.06) occurred in districts with the lowest (vs highest) Municipal Human Development Index (ie, an index that assesses longevity, education, and income). The risk of microcephaly was significantly higher where rates of larvae density (IRR = 2.31; 95% CI, 1.19-4.50) and larvae detection (IRR = 2.04; 95% CI, 1.05-4.00) were higher and rates of sewage system (IRR = 2.20; 95% CI, 1.16-4.18) and garbage collection (IRR = 1.96; 95% CI, 0.99-3.88) were lower. Newborns with microcephaly lived predominantly in the poorest areas and in a high-risk cluster (relative risk = 1.89, P = .01) in the north., Conclusions: The disproportionate incidence of microcephaly in newborns in poor areas of Recife reinforces the need for government and public health authorities to formulate policies that promote social equity and support for families and their children with microcephaly.

Recent studies have suggested the possible effect of dairy product intake on cardiovascular risk markers, including arterial stiffness. Our aim was to investigate whether dairy food intake is associated with arterial stiffness, which we assessed by carotid-femoral pulse wave velocity (cfPWV) and pulse pressure (PP) in a cross-sectional analysis of baseline data (2008–2010; n = 12,892) of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Dairy consumption was evaluated with a validated food-frequency questionnaire (FFQ) by computing servings per day for total and subgroups of dairy products. Dairy consumption was described in four categories (≤1 serving/day to >4 servings/day). Covariance analysis (ANCOVA) was used to compare cfPWV across increasing intake of dairy food, adjusting for confounding factors, including non-dairy food groups. The intake of total dairy was inversely associated with cfPWV and PP (–0.13 m/s and –1.3 mmHg, from the lowest and to the highest category of dairy intake). Low-fat dairy, fermented dairy and cheese showed an inverse relationship with cfPWV and PP. These findings suggest a beneficial effect of dairy consumption to reduce arterial stiffness. However, further evidence from longitudinal studies or long-term intervention is needed to support reduction of cfPWV and PP mediating the beneficial effects of dairy products on cardiovascular health.

DNA is considered one of the most promising targets of molecules with anticancer activity potential. Its key role in various cell division mechanisms, which commands the intense multiplication of tumor cells, is considered in studies with compounds whose mechanisms of action suggest likeliness of interaction. In addition, inhibition of enzymes that actively participate in biological functions of cells such as Topoisomerase, is seen as a primary factor for conducting several events that result in cell death. Discovery of new anticancer chemotherapeutical capable of interacting with DNA and inhibiting Topoisomerase enzymes is highlighted in anticancer research. The present review aims at showing through distinct biological tests the performance of different candidates to anticancer drugs and their respective chemical modifications, which are crucial and/or determinant for DNA affinity and inhibition of important enzymes in cells' vital processe to either separately or synergistically optimize anticancer activity., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Objective: Identify the factors associated with the age-standardised breast cancer mortality rate in the municipalities of State of São Paulo (SSP), Brazil, in the period from 2006 to 2012., Design: Ecological study of the breast cancer mortality rate standardised by age, as the dependent variable, having each of the 645 municipalities in the SSP as the unit of analysis., Settings: The female resident population aged 15 years or older, by age group and municipality, in 2009 (mid-term), obtained from public dataset (Informatics Department of the Unified Health System)., Participants: Women 15 years or older who died of breast cancer in the SSP were selected for the calculation of the breast cancer mortality rate, according to the municipality and age group, from 2006 to 2012., Main Outcome Measures: Mortality rates for each municipality calculated by the direct standardisation method, using the age structure of the population of SSP in 2009 as the standard., Results: In the final linear regression model, breast cancer mortality, in the municipal level, was directly associated with rates of nulliparity (p<0.0001), mammography (p<0.0001) and private healthcare (p=0.006)., Conclusions: The findings that mammography ratio was associated, in the municipal level, with increased mortality add to the evidence of a probable overestimation of benefits and underestimation of risks associated with this form of screening. The same paradoxical trend of increased mortality with screening was found in recent individual-level studies, indicating the need to expand informed choice for patients, primary prevention actions and individualised screening. Additional studies should be conducted to explore if there is a causality link in this association., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Patients suffering from hypoventilation and pulmonary expansion deficit are at increased risk of developing pulmonary complications such as atelectasis, pneumonia or pleural effusion. These complications can increase the length of stay and spending on health, and generate long-term functional impairment. This study aims to produce a therapeutic alternative to the traditional method of lung re-expansion through incentive spirometry (IS) using the game therapy to build an innovative system. This system makes use of infrared and Bluetooth communication technology to associate the game therapy to EI. At the end of the system implementation, we expect to obtain good adhesion of the patient and the physiotherapists.

Objective: To compare the efficacy of platelet rich plasma (PRP) against corticosteroid on the treatment of trochanteric pain syndrome . , Methods: From July 2011 to November 2012, eighteen patients (20 hips) with trochanter pain syndrome were randomized in two groups and treated with platelet rich plasma or triamcinolone infiltration guided by ultrasound. Pain and function were evaluated prior to the intervention and after 10, 30 and 60 days, through the Facial Expressions Scale for Pain and the Western Ontario McMaster and Harris Hip Score questionnaires. Inter-group analysis was performed by Student t-test and intragroup analysis by ANOVA, followed by Bonferroni post hoc test. Statistical significance was set at p <0.05 . , Results: There was no difference between the groups. The triamcinolone group showed pain reduction (p=0.004) and improved function (p=0.036) through the Harris Hip Score questionnaire at 10, 30 and 60 days after treatment, when compared with the pre- intervention period. The platelet rich plasma group showed no statistical improvement in any of the variables . , Conclusion: Up to 60 days, PRP infiltration has no influence on pain relief and function improvement in trochanteric syndrome treatment. Level of Evidence II, Prospective Comparative Study. , Competing Interests: All the authors declare that there is no potential conflict of interest referring to this article

One of the waste products of the industrial process of the sugar and alcohol agribusiness is filter cake (FC). This waste product has high levels of organic matter, mainly proteins and lipids, and is rich in calcium, nitrogen, potassium and phosphorous. In this work we characterized samples of FC from sugar and alcohol industries located in sugarcane-producing regions in Brazil and assessed the adsorption of potentially toxic metals (Cu(II), Cd(II), Pb(II), Ni(II) and Cr(III)) by this waste in mono- and multi-elemental systems, seeking to use FC as an adsorbent in contaminated environments. The characterization of FCs showed significant differences between the samples and the adsorption studies showed retention of over 90% of potentially toxic metals. In a competitive environment (multi-metallic solution), the FC was effective in adsorbing all metals except lead, but less effective compared to the mono-metallic solution. These results show the potential for use of this residue as an adsorbent in contaminated environments.

A series of thiophene-2-thiosemicarbazones derivatives (5-14) was synthesized, characterized and evaluated for their antitumor activity. They were tested in vitro against human tumor cell lines through the colorimetric method. The results revealed that compounds 7 and 9 were the most effective in inhibiting 50% of the cell growth after 48 h of treatment. As compound 7 showed a potent antiproliferative profile, it has been chosen for further studies in 786-0 cell line by flow cytometry. Treatments with compound 7 (50 μM) induced early phosphatidylserine exposure after 18 h of exposure and this process progressed phosphatidylserine exposure with loss of cell membrane integrity after 24 h of treatment, suggesting a time-dependent cell death process. Regarding the cell cycle profile, no changes were observed after treatment with compound 7 (25 μM), suggesting a mechanism of cell death independent on the cell cycle. The in vivo studies show that compound 7 possess low acute toxicity, being the doses of 30-300 mgKg(-1) chosen for studies in Ehrlich solid tumor model in mice. All doses were able to inhibit tumor development being the lowest one the most effective. Our findings highlight thiophene-2-thiosemicarbazones as a promising class of compounds for further studies concerning new anticancer therapies., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Purposes: To validate a teleophthalmology mobile system aimed at improving and providing eye urgency screenings in remote and poor area settings in Brazil. The system enables one or more ophthalmologists to remotely examine a patient's condition and submit a decision describing the gravity of the case. If necessary, the patient can be forwarded to a hospital for further consultation., Methods: A cellphone (Nexus One model, with a 5 megapixel camera) was used to collect data and pictures from 100 randomly selected patients at the Ophthalmology Emergency Room located at the General Hospital of the Federal University of São Paulo (UNIFESP). Data was then sent remotely to an online recording system to be reviewed by an ophthalmologist who provided feedback regarding the state of ocular urgency. RESULTS were then compared to the gold standard diagnosis provided at the hospital., Results: The diagnosis of urgency was given by two ophthalmologists: one in the hospital (gold standard) and one remotely. When we compared both diagnoses we obtained results of 81.94% specificity, 92.85% sensitivity, and 85% accuracy, with a negative predictive value of 96.72%. This work also included a processing time analysis, resulting in an average time of 8.6 min per patient for remote consultations., Conclusions: This study is the first that has used only a cellphone for diagnosing the urgency of ocular cases. Based on our results, the system can provide a reliable distinction between urgent and non-urgent situations and can offer a viable alternative for the servicing of underprivileged areas. In screening techniques, the most important outcome is to identify urgent cases with a high level of sensitivity and predictive negative value. Thus, our results demonstrate that this tool is robust and we suggest that a major study aimed to verify its efficiency in resource-poor areas should be initiated.

The aim of this work is to evaluate the antimicrobial and cytotoxic activity of a formulation containing silver nanoparticles and chitosan, provisionally called nano silver fluoride (NSF), against Streptococcus mutans in comparison to chlorhexidine and silver diamine fluoride (SDF). The product was characterised by transmission electron microscopy and UV-Vis absorption spectroscopy. The minimum inhibition concentration (MIC) was evaluated by the spectrophotometric microdilution method and turbidity. The minimum bactericide concentration (MBC) was evaluated in brain heart infusion plates, and cytotoxicity was evaluated by haemolytic activity. The MIC and MBC for NSF were, respectively, 33.54 ± 14.52 and 50.32 µg/mL; for SDF were 33.33 ± 14.43 and 50.0 µg/mL, respectively; and for CHX were 3.3 ± 0.5 and 6 µg/mL, respectively. An ANOVA for MIC gave P = 0.032, and for MBC P = 0.035. The cytotoxic effect of NSF compared to SDF demonstrated a statistically significant difference in the MIC value (t test P < 0.05). The NSF formulation may be effective against S. mutans with much lower doses, may have lower toxicity than SDF, and may not stain teeth.

Background: Untreated dental caries in children remains a public health challenge in poor communities., Objectives: This prospective controlled clinical trial investigated the effectiveness of a new anti-caries agent, Nano Silver Fluoride (NSF), applied once a year to arrest caries in children., Methods: One hundred thirty decayed primary teeth were randomly divided into two groups: NSF as the experimental agent and water as the control group. Teeth were clinically diagnosed and treated by one masked examiner and followed up at seven days and five and 12 months by another calibrated examiner who was blinded to the type of treatment. The criteria of the ICDAS II were followed to determine the activity of lesion and the diagnosis of caries. The Pearson's chi-square test was used to compare the groups during different follow-up exams., Results: At seven days, 81% of teeth in the NSF group exhibited arrested caries, whereas in controls, no teeth had arrested decay (p<0.001) [PF, prevented fraction=81%]. After five months, the NSF group had 72.7% with arrested decay, and the control group had 27.4% (p<0.001) [PF=62.5%]. At 12 months, 66.7% of the lesions treated with NSF were still arrested, while the control group had 34.7% remaining arrested (p=0.003) [PF=50%]. The number need to treat (NNT) at five months was two, and at 12 months, the number was three., Clinical Significance: The NSF formulation is effective to arrest active dentine caries and not stain teeth., Conclusions: NSF was demonstrated to be effective in arresting caries in children in poor communities., (Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction: Sedation overuse is frequent and possibly associated with poor outcomes in the intensive care unit (ICU) patients. However, the association of early oversedation with clinical outcomes has not been thoroughly evaluated. The aim of this study was to assess the association of early sedation strategies with outcomes of critically ill adult patients under mechanical ventilation (MV)., Methods: A secondary analysis of a multicenter prospective cohort conducted in 45 Brazilian ICUs, including adult patients requiring ventilatory support and sedation in the first 48 hours of ICU admissions, was performed. Sedation depth was evaluated after 48 hours of MV. Multivariate analysis was used to identify variables associated with hospital mortality., Results: A total of 322 patients were evaluated. Overall, ICU and hospital mortality rates were 30.4% and 38.8%, respectively. Deep sedation was observed in 113 patients (35.1%). Longer duration of ventilatory support was observed (7 (4 to 10) versus 5 (3 to 9) days, P = 0.041) and more tracheostomies were performed in the deep sedation group (38.9% versus 22%, P = 0.001) despite similar PaO2/FiO2 ratios and acute respiratory distress syndrome (ARDS) severity. In a multivariate analysis, age (Odds Ratio (OR) 1.02; 95% confidence interval (CI) 1.00 to 1.03), Charlson Comorbidity Index >2 (OR 2.06; 95% CI, 1.44 to 2.94), Simplified Acute Physiology Score 3 (SAPS 3) score (OR 1.02; CI 95%, 1.00 to 1.04), severe ARDS (OR 1.44; CI 95%, 1.09 to 1.91) and deep sedation (OR 2.36; CI 95%, 1.31 to 4.25) were independently associated with increased hospital mortality., Conclusions: Early deep sedation is associated with adverse outcomes and constitutes an independent predictor of hospital mortality in mechanically ventilated patients.

This study assessed the degree of adherence and drug-related awareness and opinions regarding the importance of guidance with respect to treatment among medical students who use antidepressants. It is a cross-sectional descriptive study, carried out in a public Medical School in the state of Sao Paulo, Brazil. Of the 289 students interviewed, 33 (11.4%) use or had already used antidepressants, with fluoxetine being the most prescribed. The nurse was not cited as being responsible for guidance on the antidepressant. Although most students had received guidance on antidepressants, they did not heed guidance and still had doubts regarding their use. There was a statistically significant association regarding the consumption of other drugs in addition to antidepressants and the existence of side effects, as well as regarding an increase of the dosage without medical consultation and the existence of such side effects. Actions are necessary to acknowledge the importance of the teaching of psychopharmacology in the training of the medical professional and for greater harmony between theory and practice.

Background:  Silver diamine fluoride (SDF) is an effective agent for the arrest of caries in children, is easy to apply and can be used outside the clinical environment. Interim restorative treatment (IRT) using glass ionomer cement has also been claimed to be a simple and effective method to arrest caries in deciduous teeth., Objective:  To examine whether, for underprivileged schoolchildren with cavities, treatment with 30% SDF gives better results than IRT for carries arrest., Method:  This randomised controlled study compares the effect of IRT (FUJI IX) with 30% SDF in 91 children aged 5-6 years., Results:  After 1 year, treatment with SDF was more effective [relative risk (RR) = 66.9%] than IRT (RR = 38.6%) for the arrest of caries; this was statistically significant (P < 0.05)., Conclusion:  The SDF technique showed better results than IRT for the arrest of cavities in deciduous teeth, indicating that its use for underprivileged communities may justify a paradigm shift in paediatric dentistry., (© 2012 FDI World Dental Federation.)

Cardiovascular diseases are currently the most common causes of morbimortality worldwide. In the context of disease prevention, actions creating favorable health environments and promoting healthy choices prove fundamental. Intervention programs with a community basis have been introduced in different countries since the beginning of the 1970s, aiming to modify cardiovascular risk factors and decrease morbidity and mortality due to cardiovascular diseases. In such experiences, the importance of public policies and cardiovascular risk vigilance systems needs to be stressed, permitting a more accurate assessment of the magnitude of the problem and the development of more cost-effective actions. The scope of this bibliographical study was to describe community-geared experiences in many countries in the campaign against cardiovascular diseases through health promotion and primary prevention of risk factors, as well as to identify in Brazil the vigilance actions of the risk factors of non-transmissible chronic diseases, stressing the strategic challenges facing the Family Health Program in tackling cardiovascular diseases.

Currently, Diabetes is a very common disease around the world, and with an increase in sedentary lifestyles, obesity and an aging population the number of people with Diabetes worldwide will increase by more than 50%. In this context, the MIT (Massachusetts Institute of Technology) developed the SANA platform, which brings the benefits of information technology to the field of healthcare. It offers healthcare delivery in remote areas, improves patient access to medical specialists for faster, higher quality, and more cost effective diagnosis and intervention. For these reasons, we developed a system for diagnosis of Diabetes using the SANA platform, called S2DIA. It is the first step towards knowing the risks for type 2 Diabetes, and it will be evaluated, especially, in remote/poor areas of Brazil.

Background: Poor adherence to non-pharmacological treatment of hypertension represents a serious challenge for public health policies in several countries. This study was conducted to compare two intervention strategies regarding the adherence of adult women to dietary changes recommended for the treatment of hypertension in a community covered by Primary Health Care Unit., Methods: This study is a randomized controlled trial of a sample composed of 28 women with hypertension enrolled in the Primary Health Care Unit located in the urban area of southeastern Brazil. The participants were already undergoing treatment for hypertension but devoid of nutritional care; and were divided into two groups, each composed of 14 individuals, who received interventions that consisted of two different strategies of nutritional guidance: monthly health education workshops alone (Group 1) and combined with family orientation through home visits (Group 2). Adherence to nutritional guidelines was evaluated by dietary, anthropometric, clinical and serum biochemical parameters, measured before and after the interventions. Knowledge on control and risk of hypertension was also investigated. The study lasted five months., Results: Mean age was 55.6 (± 2.8) and 50.7 (± 6.5) in the groups 1 and 2, respectively. The home orientation strategy promoted greater adherence to dietary changes, leading to a statistically significant improvement in the clinical, anthropometric, biochemical and dietary parameters. The group 2 reduced the consumption of risk foods (p = 0.01), oil (p = 0.002) and sugar (p = 0.02), and decreased body mass index (-0.7 kg/m2; p = 0.01); waist circumference (-4.2 cm; p = 0.001), systolic blood pressure (-13 mm HG; p = 0.004) and glycemia (-18.9 mg/dl; p = 0. 01). In group 1 only waist circumference (-2 cm; p = 0.01) changed significantly., Conclusion: Nutritional orientations at the household level were more effective with regard to the adherence of individuals to non-pharmacological treatment of hypertension, regarding the reduction of clinical and behavioral risk parameters.

Some diseases, such as hypertension, require a close control of the patient's blood pressure. This is even more critical when that patient is going through--or has just underwent--a surgical procedure In such situations, reducing blood pressure to normal levels is of paramount importance. Usually, this demanding and time consuming monitoring is done manually by clinical personnel and are subject to mistakes and inconsistent practices. In this paper, we propose a solution to the manual monitoring through the design and implementation of an embedded PID controller to handle blood pressure, integrated to an automated monitoring system to assist in detecting anomalies and to optimize the process of patient care.