Dexmedetomidine is a potent adrenergic alpha-2 agonist, and analgesic, sedative, anxiolytic and sympatholytic. Given there have been reports of dexmedetomidine associated temperature changes, in ...which these events have been associated with complications, our objective was to describe both temperature increase and decrease, during the intra and postoperative period (initial 24 hours), and factors associated, in patients who received dexmedetomidine for anesthesia/sedation in the surgical suite.
Retrospective observational study, analyzing charts of patients ≥ 18 years submitted to anesthesia/sedation with dexmedetomidine, between 1/1/2017 and 31/12/2017. Upper temperature threshold was considered ≥ 37.8 °C, and lower, < 35 °C. The association with dexmedetomidine was assessed by the OMS/UMC causality system and by the Naranjo algorithm.
The sample included 42 patients who received dexmedetomidine and whose temperature data were available, with predominance of men 26 (62%), 49.4/16.5 years old (mean/standard deviation), and weight 65/35.8 kg. None of the patients presented intraoperative temperature equal to or above 37.8 °C or below 35 °C. During the postoperative period, one patient presented an increase ≥ 37.8 °C (2.4%) and three, temperature decrease < 35 °C (7%). Surgery/anesthesia time and exposure time to dexmedetomidine were not appropriate linear predictors of maximum temperature. Older age (p < 0.01), longer exposure to dexmedetomidine (p < 0.05) and shorter surgery time (p < 0.01) were significant linear predictors for lower minimum temperature.
Increase ≥ 37.8 °C/decrease < 35 °C of temperature possibly associated with dexmedetomidine did not occur in the intraoperative period and had a low frequency during the postoperative period.
Summary
Clustered regularly interspaced short palindromic repeats (CRISPRs) are composed of an array of short DNA repeat sequences separated by unique spacer sequences that are flanked by associated ...(Cas) genes. CRISPR‐Cas systems are found in the genomes of several microbes and can act as an adaptive immune mechanism against invading foreign nucleic acids, such as phage genomes. Here, we studied the CRISPR‐Cas systems in plant‐pathogenic bacteria of the Ralstonia solanacearum species complex (RSSC). A CRISPR‐Cas system was found in 31% of RSSC genomes present in public databases. Specifically, CRISPR‐Cas types I‐E and II‐C were found, with I‐E being the most common. The presence of the same CRISPR‐Cas types in distinct Ralstonia phylotypes and species suggests the acquisition of the system by a common ancestor before Ralstonia species segregation. In addition, a Cas1 phylogeny (I‐E type) showed a perfect geographical segregation of phylotypes, supporting an ancient acquisition. Ralstoniasolanacearum strains CFBP2957 and K60T were challenged with a virulent phage, and the CRISPR arrays of bacteriophage‐insensitive mutants (BIMs) were analysed. No new spacer acquisition was detected in the analysed BIMs. The functionality of the CRISPR‐Cas interference step was also tested in R. solanacearum CFBP2957 using a spacer‐protospacer adjacent motif (PAM) delivery system, and no resistance was observed against phage phiAP1. Our results show that the CRISPR‐Cas system in R. solanacearum CFBP2957 is not its primary antiviral strategy.
Background. Transcutaneous electrical nerve stimulation (TENS) has been used as analgesic therapy in many diseases. It is already known that studies that have observed the relationship between pain ...and cytokines have found that patients who report less severe pain have less production of proinflammatory cytokines. However, one another accepted mechanism is that decreasing proinflammatory cytokines results in decreased pain intensity. Analyzing the literature, the authors describe that, in addition to the analgesic effect, TENS has shown systemic effects, and clinically, the reduction of proinflammatory cytokines could be a protective factor against inflammation. To test the inflammatory effect of TENS, we researched the literature for clinical conditions that suggest that proinflammatory cytokines are one of the main mediators of the disease process. Chronic inflammation is one of the risk factors mentioned for the development of a new cancer; at the same time, it is indicated as an indicator of the worst prognosis. Studies also suggest that the worst prognosis of breast cancer, one of the types with the highest incidence in the world, may be related to increased inflammatory activity. Considering that inflammation is increased in breast cancer and that TENS can reduce proinflammatory cytokines even without blocking the pain pathway, our hypothesis is that the anti-inflammatory effect of TENS can bring benefits to these patients. The aim of this study will be to evaluate the effect of TENS on blood reduction of proinflammatory cytokines in breast cancer patients. Methods. This study will evaluate at least 59 patients, over 18 years of age, diagnosed with breast cancer, but who have not yet started any treatment. All patients will be submitted to TENS intervention (Ibramed, Model Neurodyn III, parameters: VIF—turn on, frequency—2-247 Hz, pulse size—50-500 μs, and intensity (mA)—maximum tolerated by the patient), and the data will be analyzed in the pre- and postintervention of each patient. The application has a total duration of 30 minutes, and 8 ml of blood will be collected before and after the intervention. Proinflammatory (IL-1, IL-2, IL-6, IL-7, and TNF-α) and anti-inflammatory (IL-4, IL-10, IL-13, and FTCβ) cytokines will be analyzed. As a primary endpoint, we will analyze the reduction in blood concentration of proinflammatory cytokines, and as secondary endpoints, we will analyze the size of the effect according to each type of proinflammatory cytokine, describe the effect size of the reduction according to the breast cancer immunohistochemistry, and analyze the effect of TENS on anti-inflammatory cytokines. This study is approved by the Research Ethics Committee (Centro Universitário FMABC, Brazil) and registered in the Brazilian Clinical Trials (Search text: RBR-10jbwh47).
Obesity is considered a global public health problem. Cesarean section has been associated with high body mass index (BMI) and increased obesity throughout life. However, this association has been ...challenged by some studies. This study aims to assess the causal effect of cesarean section on the BMI of children aged 1-3 years. This is a cohort study of 2,181 children aged 1-3 years, born in 2010, obtained from the BRISA Birth Cohort, in São Luís, state of Maranhão, Brazil. Sociodemographic variables, maternal characteristics, type of childbirth, morbidity, anthropometric measurements, and BMI were assessed. Marginal structural models with a counterfactual approach were used to check the causal effect of the type of childbirth on obesity, weighted by the inverse probability of selection and exposure. Out of the 2,181 children assessed (52% female), 50.6% were born by cesarean section, 5.9% of the newborn infants were large for gestational age, and 10.7% of them had excess weight. No causal effect of cesarean section on BMI was observed (coefficient = -0.004; 95%CI: -0.136; 0.127; p = 0.948). Cesarean section did not have a causal effect on the BMI of children aged 1-3 years.
Estrogen receptor-positive (ER
) breast cancer is the most diagnosed subtype, with aromatase inhibitors (AIs) being one of the therapeutic drug types used in the clinic. However, endocrine resistance ...may develop after prolonged treatment, and different approaches, such as combining endocrine and targeted therapies, have been applied. Recently, we demonstrated that cannabidiol (CBD) induces anti-tumor actions in ER
breast cancer cells by targeting aromatase and ERs. Considering this, we studied, in vitro, whether CBD when combined with AIs could improve their effectiveness.
MCF-7aro cells were used and the effects on cell viability and on the modulation of specific targets were investigated.
CBD when combined with anastrozole (Ana) and letrozole (Let) caused no beneficial effect in comparison to the isolated AIs. In contrast, when combined with the AI exemestane (Exe), CBD potentiated its pro-cell death effects, abolished its estrogen-like effect, impaired ERα activation, and prevented its oncogenic role on the androgen receptor (AR). Moreover, this combination inhibited ERK
activation, promoting apoptosis. The study of the hormonal microenvironment suggests that this combination should not be applied in early stages of ER
breast tumors.
Contrary to Ana and Let, this study highlights the potential benefits of combining CBD with Exe to improve breast cancer treatment and opens up the possibility of new therapeutic approaches comprising the use of cannabinoids.
Sugar-sweetened beverages (SSB) consumption may be associated with a reduction in bone mineral density (BMD). The aim of this study was to evaluate the association between the consumption of SSB and ...BMD among young people. We performed a cross-sectional study that evaluated 6620 young people (18-23 years of age) from three Brazilian birth cohorts (Ribeirão Preto, Pelotas, and São Luís). We analyzed the daily frequency and the amount and energy contribution of the SSB, which were obtained through a food frequency questionnaire. Total body and lumbar spine BMD (g/cm
), measured by dual-energy X-ray absorptiometry, were the outcomes. Unadjusted linear regression models, adjusted for sex, socioeconomic class, physical activity, smoking, alcohol consumption, and body mass index were used. The highest tertile of SSB consumption frequency (2.1-16.7 times/day) was associated with a lower lumbar spine BMD (β = -0.009; 95% CI: -0.017; -0.001; standardized β = -0.03). This association persisted after adjustment for confounders (β = -0.008; 95% CI: -0.016; -0.001; standardized β = -0.03). No association was observed between SSB consumption frequency and total body BMD or between the amount and energy contribution of SSB and total body or lumbar spine BMD. A high frequency of SSB consumption was associated with a low lumbar spine BMD.
Alternative sources of fuel have been a concern in the last few decades. The growth of urbanization and industrialization will lead to the exhaustion of fossil fuels, attracting studies on ...alternative routes. The main aim of this study was to produce biodiesel from waste cooking oil (WCO) by methyl transesterification using sodium hydroxide as a catalyst. For this, the physicochemical parameters of biodiesel were studied in triplicate (density, acidity, saponification, viscosity, corrosiveness to copper, visual appearance, and cloud point). An analysis by thin layer chromatography and infrared spectrometry was also performed. The increase in yield (83.3%) was directly proportional to the increase in the catalyst (0.22 g of NaOH). The infrared absorption spectra of WCO and biodiesel showed the presence of common and singular bands of each material. Furthermore, a simple and low-cost mechanism was proposed for purifying glycerol. The spectra of glycerol versus purified glycerin showed that the glycerin produced was pure, being used in the formulation of bioplastic. The product was checked for biodegradation and photodegradation, with incredible soil-degradation times of 180 days and photodegradation of only 60 days. In this way, biodiesel production from WCO showed environmentally friendly proposals and applicability. As the next steps, it is necessary to test the biodiesel produced in combustion engines and improve the bioplastic production, including a spectroscopic characterization and extensive biodegradation testing.
This paper aims to present the results of a series of several Brazilian institutions that have been carrying out lung cancer screening (LCS).
This is a retrospective, cohort study, with follow-up of ...individuals of both sexes, with a heavy smoking history, who participated in LCS programs between December 2013 and January 2021 in six Brazilian institutions located in the states of São Paulo, Rio Grande do Sul, and Bahia.
Three thousand four hundred seventy individuals were included, of which 59.8% were male (n = 2,074) and 50.6% were current smokers (n = 1,758), with 60.7 years (standard deviation 8.8 years). Lung-RADS 4 was observed in 233 (6.7%) patients. Biopsy was indicated by minimally invasive methods in 122 patients (3.5%). Two patients who demonstrated false-negative biopsies and lung cancer were diagnosed in follow-up. Diagnosis of lung cancer was observed in 74 patients (prevalence rate of 2.1%), with 52 (70.3%) in stage I or II. Granulomatous disease was found in 20 patients. There were no statistical differences in the incidence of lung cancer, biopsies, granulomatous disease, and Lung-RADS 4 nodules between public and private patients.
There are still many challenges and obstacles in the implementation of LCS in developing countries; however, our multi-institutional data were possible to obtain satisfactory results in these scenarios and to achieve similar results to the main international studies. Granulomatous diseases did not increase the number of lung biopsies. The authors hope that it could stimulate the creation of organized screening programs in regions still endemic for tuberculosis and other granulomatous diseases.
To analyze the relationship between pain, the fear of falling and functional performance in older people living in a long-stay institution (LSI) in the interior of northeastern Brazil.
A ...cross-sectional study was conducted with 133 older residents in an LSI in the State of Paraíba. The instruments used for data collection were the Geriatric Pain Measure (GPM), the Falls Efficacy Scale-International (FES-I) and the Short Physical Performance Battery (SPPB).
Pain was reported by 57.5% of those evaluated, 48% being classified as chronic pain and presenting an average of 25.2 in the GPM. As for physical performance, assessed using the SPPB, the 133 older residents showed moderate to poor performance, with an average of 6.43 (±2.96) on the scale. By correlating the adjusted GPM values with the FES-I, a weak and statistically significant positive correlation was obtained (ρ = 0.31:
< 0.001).
It can be concluded that those who reported pain had a worse performance in the applied tests, in addition to having higher scores on the scale referring to a fear of falling.
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