Abstract Foodborne diseases are common illnesses caused by the consumption of food contaminated with microorganisms, such as viruses, fungi, bacteria, and protozoa. Every year, 600 million people ...become ill and 420,000 people die as a result of consuming contaminated food. Therefore, food safety is an important issue. In this study, samples of homemade spiced mayonnaise and self-serve acai sold in the city of Araguaína, Tocantins, Brazil were analyzed for microbiological contaminants. Acai was collected from 10 stores, one sample from each store, and tested for mold, yeast, and coliforms, as well as coliform identification and total and thermotolerant coliform counts. Mayonnaise was collected from 20 snack bars, one sample from each. These samples were inoculated on MacConkey and Salmonella Shigella agar plates, and the plates were analyzed for growth. Salmonella spp. were detected in some Mayonnaise samples, and coliforms were detected in all acai samples; 60% of samples had thermotolerant coliforms, and only 40% were within the limits established by ANVISA. The collected samples of mayonnaise and acai were contaminated with molds and yeasts above the established limit of 103 CFU/g. Thus, the analyzed mayonnaise and acai samples were contaminated and unfit for consumption, demonstrating the importance of hygienic-sanitary measures in food handling.
Resumo As doenças transmitidas por alimentos são doenças comuns causadas pelo consumo de alimentos contaminados com microrganismos, como vírus, fungos, bactérias e protozoários. Todos os anos, 600 milhões de pessoas ficam doentes e 420.000 pessoas morrem como resultado do consumo de alimentos contaminados. Portanto, a segurança alimentar é uma questão importante. Neste estudo, amostras de maionese temperada caseira e açaí self-service vendidas na cidade de Araguaína, Tocantins, Brasil foram analisadas quanto a contaminantes microbiológicos. O açaí foi coletado em 10 lojas, uma amostra de cada loja, e testado para mofo, levedura e coliformes, bem como identificação de coliformes e contagem de coliformes totais e termotolerantes. A maionese foi coletada de 20 lanchonetes, sendo uma amostra de cada. Essas amostras foram inoculadas em placas de ágar MacConkey e Salmonella Shigella, e as placas foram analisadas quanto ao crescimento. Salmonela spp. foram detectados em algumas amostras de maionese e coliformes foram detectados em todas as amostras de açaí; 60% das amostras apresentaram coliformes termotolerantes, e apenas 40% estavam dentro dos limites estabelecidos pela ANVISA. As amostras coletadas de maionese e açaí estavam contaminadas com bolores e leveduras acima do limite estabelecido de 103 UFC/g. Assim, as amostras de maionese e açaí analisadas estavam contaminadas e impróprias para o consumo, demonstrando a importância das medidas higiênico-sanitárias na manipulação de alimentos.
Testing of factor Xa inhibitors for the prevention of cardiovascular events in patients with rheumatic heart disease-associated atrial fibrillation has been limited.
We enrolled patients with atrial ...fibrillation and echocardiographically documented rheumatic heart disease who had any of the following: a CHA
DS
VASc score of at least 2 (on a scale from 0 to 9, with higher scores indicating a higher risk of stroke), a mitral-valve area of no more than 2 cm
, left atrial spontaneous echo contrast, or left atrial thrombus. Patients were randomly assigned to receive standard doses of rivaroxaban or dose-adjusted vitamin K antagonist. The primary efficacy outcome was a composite of stroke, systemic embolism, myocardial infarction, or death from vascular (cardiac or noncardiac) or unknown causes. We hypothesized that rivaroxaban therapy would be noninferior to vitamin K antagonist therapy. The primary safety outcome was major bleeding according to the International Society of Thrombosis and Hemostasis.
Of 4565 enrolled patients, 4531 were included in the final analysis. The mean age of the patients was 50.5 years, and 72.3% were women. Permanent discontinuation of trial medication was more common with rivaroxaban than with vitamin K antagonist therapy at all visits. In the intention-to-treat analysis, 560 patients in the rivaroxaban group and 446 in the vitamin K antagonist group had a primary-outcome event. Survival curves were nonproportional. The restricted mean survival time was 1599 days in the rivaroxaban group and 1675 days in the vitamin K antagonist group (difference, -76 days; 95% confidence interval CI, -121 to -31; P<0.001). A higher incidence of death occurred in the rivaroxaban group than in the vitamin K antagonist group (restricted mean survival time, 1608 days vs. 1680 days; difference, -72 days; 95% CI, -117 to -28). No significant between-group difference in the rate of major bleeding was noted.
Among patients with rheumatic heart disease-associated atrial fibrillation, vitamin K antagonist therapy led to a lower rate of a composite of cardiovascular events or death than rivaroxaban therapy, without a higher rate of bleeding. (Funded by Bayer; INVICTUS ClinicalTrials.gov number, NCT02832544.).
Indigenous people have been managing fire‐prone landscapes for millennia, especially in tropical savannas, thereby maintaining carbon stocks and pyrodiversity and ensuring food security. In some ...indigenous lands in Brazil, fire brigades are composed of indigenous people, integrating their traditional knowledge in Brazilian fire management policies; however, the effectiveness of their management is largely undocumented. Nevertheless, we need to know the effectiveness of indigenous fire brigades and their influence on fire patterns.
Here, we evaluate an 18‐year historical series of fire patterns and burn scars, comparing periods with and without indigenous brigade activity, to describe the role of indigenous fire brigades in the Kadiwéu Indigenous Territory. In this Indigenous Territory, fire brigades composed of indigenous people have been instituted, trained and maintained by the National Center of Prevention and Combat of Wildfire (PREVFOGO/IBAMA) since 2009. These brigades are responsible for fire management throughout the Kadiwéu Indigenous Territory using controlled burning, prescribed burning and combating wildfires.
We found that fire management by the indigenous brigades has reduced fire frequency by 80% in the areas with high fire frequency (over 70% of the analysed time). Management also reduced the size of the area burned by 53% and the influence of climate over the total area burned. According to our models, the area affected by fires is mainly influenced by annual rainfall in the absence of indigenous brigades; in contrast, climatic factors could not explain the variation in the burned area in the period without indigenous brigades.
Synthesis and applications. The fire management realized by the indigenous brigades can modify the fire regime. These changes in the fire regime can include: changes in spatial patterns, the magnitude of fires and reduction in the influence of climate on fire regimes. Hence, the management carried out by the indigenous brigades can be considered an important tool for fire management. In addition to demonstrating the importance of programs that integrate traditional indigenous knowledge with fire management policies, such as the Integrated Fire Management (IFM), to construct effective management strategies.
Resumo
Os povos indígenas vêm gerindo paisagens propensas ao fogo há milênios, especialmente nas savanas tropicais, mantendo assim os estoques de carbono e a pirodiversidade e garantindo a segurança alimentar. Em algumas terras indígenas no Brasil, as brigadas de incêndio são compostas por indígenas, integrando seus conhecimentos tradicionais nas políticas de manejo de incêndios; no entanto, a eficácia da sua gestão é em grande parte não documentada. Deste modo, precisamos conhecer a eficácia das brigadas de incêndio indígenas e sua influência nos padrões de incêndio.
Neste estudo, avaliamos uma série histórica de 18 anos de padrões de incêndio e cicatrizes de queimadas, comparando períodos com e sem atividade de brigada indígena, para descrever o papel das brigadas indígenas na Terra Indígena Kadiwéu. Neste Território Indígena, desde 2009, brigadas de incêndio compostas por indígenas são instituídas, treinadas e mantidas pelo Centro Nacional de Prevenção e Combate a Incêndios (PREVFOGO/IBAMA). Estas brigadas são responsáveis pelo manejo do fogo em todo o território Kadwéu, utilizando técnicas como a queima prescrita, queima controlada e o combate a incêndios.
Constatamos que o manejo de incêndios realizado pelas brigadas indígenas reduziu a frequência de incêndios em 80% nas áreas com alta frequência de incêndios (mais de 70% do tempo analisado). O manejo também reduziu em 53% o tamanho da área anual queimada e a influência do clima sobre a área total queimada. De acordo com nossos modelos, a área afetada pelos incêndios é influenciada principalmente pelas chuvas anuais na ausência de brigadas indígenas; em contrapartida, os fatores climáticos não puderam explicar a variação da área queimada no período sem brigadas indígenas.
Síntese e aplicações. O manejo do fogo realizado pelas brigadas indígenas pode modificar o regime de fogo. Essas alterações no regime de fogo podem incluir: mudanças nos padrões espaciais, na magnitude dos incêndios e redução na influência do clima sobre os regimes de fogo. Assim, o manejo realizado pelas brigadas indígenas pode ser considerado uma importante ferramenta para o manejo do fogo. Além disso, demonstra a importância de programas que integrem o conhecimento tradicional indígena com políticas de manejo do fogo, como o Manejo Integrado do Fogo (MFI), para a construção de estratégias de manejo eficazes.
The fire management realized by the indigenous brigades can modify the fire regime. These changes in the fire regime can include: changes in spatial patterns, the magnitude of fires and reduction in the influence of climate on fire regimes. Hence, the management carried out by the indigenous brigades can be considered an important tool for fire management. In addition, demonstrates the importance of programs that integrate traditional indigenous knowledge with fire management policies, such as the Integrated Fire Management (IFM), to construct effective management strategies.
Understanding the ecological and toxicological relationship between genetically modified cultivars (GM) and biological control agents is of great importance for discussions related to the ...compatability of GM cultivars and integrated management strategies for pest resistance. The present study evaluated the search behavior and predatory capacity of Orius insidiosus (Say) (Hemiptera: Anthocoridae) and Doru luteipes (Scudder) (Dermaptera: Forficulidae) on eggs and caterpillars of Spodoptera frugiperda (J. E. Smith) (Lepidoptera: Noctuidae) resistant or not to the protein Cry1F expressed in Bt corn. To determine the search time, a stopwatch was run until the capture of the first prey, predation capacity was evaluated by counting the prey remaining after 24 hours of infestation. The injuries of S. frugiperda in genetically modified and conventional corn in the presence and absence of predators was also evaluated. The predators were not able to distinguish between resistant and susceptible prey (eggs or caterpillars), given the predatory behaviour observed. There was no difference in searching time or predatory capacity between the predators for eggs and caterpillars of either resistant or susceptible S. frugiperda. In the presence of predators, the injury scores for resistant S. frugiperda on the Bt corn plants were lower. It was concluded that O. insidiosus and D. luteipes did not notice the presence of the protein Cry1F in the prey S. frugiperda, which may facilitate the combined use of GM corn and biological control in integrated management programs and for management of pest resistance.
Multiple organ dysfunction is the most severe outcome of sepsis progression and is highly correlated with a worse prognosis. Excessive neutrophil extracellular traps (NETs) are critical players in ...the development of organ failure during sepsis. Therefore, interventions targeting NET release would likely effectively prevent NET-based organ injury associated with this disease. Herein, we demonstrate that the pore-forming protein gasdermin D (GSDMD) is active in neutrophils from septic humans and mice and plays a crucial role in NET release. Inhibition of GSDMD with disulfiram or genic deletion abrogated NET formation, reducing multiple organ dysfunction and sepsis lethality. Mechanistically, we demonstrate that during sepsis, activation of the caspase-11/GSDMD pathway controls NET release by neutrophils during sepsis. In summary, our findings uncover a novel therapeutic use for disulfiram and suggest that GSDMD is a therapeutic target to improve sepsis treatment.
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•Polysaccharide from Acanthophora spicifera (PAs) is an agar-type polysaccharide.•PAs possesses a high sulfate content.•PAs reduces the oxidative stress and enhances defense ...mechanisms of the gastric mucosa.
In this study, a polysaccharide from marine alga Acanthophora spicifera (PAs) was isolated and structurally characterized. Its protective potential against chemically-induced gastric mucosa injury was evaluated. The gel permeation chromatography experiments and spectroscopy spectrum showed that PAs is a sulfated polysaccharide with a high molecular mass (6.98 × 105g/mol) and degree of sulfation of 1.23, exhibiting structural characteristic typical of an agar-type polysaccharide. Experimental results demonstrated that PAs reduced the hemorrhagic gastric injury, in a dose-dependent manner. Additionally, PAs reduced the intense gastric oxidative stress, measured by glutathione (GSH) and malondialdehyde (MDA) levels. PAs also prevented the reduction of mucus levels adhered to the gastric mucosa, promoted by the aggressive effect of ethanol. In summary, the sulfated polysaccharide from A. spicifera protected the gastric mucosa through the prevention of lipid peroxidation and enhanced the defense mechanisms of the gastric mucosa, suggesting as a promising functional food as gastroprotective agent.
•Hyperglycemic activate caspase-1 and downstream inflammatory cytokine production.•Inflammatory mediators contribute insulin-resistance during diabetic condition.•In mild gestational hyperglycemia ...the activation of inflammasomes may be associated with complications.
This study was based on the hypothesis that IL-1β and its central regulator, the inflammasome, may play a role in the inflammatory condition exhibited by placental tissues from mothers with different gestational hyperglycemia levels. Pregnant women were classified according to the glycemic reference as non-diabetic (n = 15), mild gestational hyperglycemia (n = 15), gestational diabetes mellitus (n = 15) and type 2 diabetes mellitus (n = 15). We investigated levels of pro-inflammatory factors in maternal plasma and placental tissues (by ELISA or immunohistochemistry) and, NFKB activity (by electrophoretic mobility shift assay) and inflammasome protein expression (by Western blot) in chorionic villous. Maternal plasma and placental levels of inflammatory factors (IL-1β, IL-6, and MCP-1) were increased during all hyperglycemic conditions. Villous stroma cells showed strong immunoreactivity to CD68. In addition, with syncytiotrophoblast, the villous stroma cells were also stained to detect iNOS, MCP-1, TLR2, and TLR4. Although the levels of protein had fluctuated in the groups, NLRP1, NLRP3, ASC, and Caspase 1 were up-regulated in all hyperglycemic groups suggesting the inflammasome may be assembled in these pregnant women. The NFKB activity also exhibited higher levels in hyperglycemic groups, which might imply in pro-inflammatory cytokines production. In summary, increased maternal glucose levels during pregnancy changed systemic and placental inflammatory patterns, which occurred in parallel with the expression of inflammasome factors and processing and secretion of the pro-inflammatory cytokine IL-1β. These results suggest an inflammatory condition in all gestational hyperglycemic conditions, even in hyperglycemia that is less severe than gestational or overt diabetes, likely associated with inflammasome activation and inflammatory cytokine secretion. Inflammasome activation as a possible source of inflammatory factors may be an important target to be considered while managing hyperglycemia and preventing adverse pregnancy outcomes.
Tuberculous pericarditis is associated with high morbidity and mortality even if antituberculosis therapy is administered. We evaluated the effects of adjunctive glucocorticoid therapy and ...Mycobacterium indicus pranii immunotherapy in patients with tuberculous pericarditis.
Using a 2-by-2 factorial design, we randomly assigned 1400 adults with definite or probable tuberculous pericarditis to either prednisolone or placebo for 6 weeks and to either M. indicus pranii or placebo, administered in five injections over the course of 3 months. Two thirds of the participants had concomitant human immunodeficiency virus (HIV) infection. The primary efficacy outcome was a composite of death, cardiac tamponade requiring pericardiocentesis, or constrictive pericarditis.
There was no significant difference in the primary outcome between patients who received prednisolone and those who received placebo (23.8% and 24.5%, respectively; hazard ratio, 0.95; 95% confidence interval CI, 0.77 to 1.18; P=0.66) or between those who received M. indicus pranii immunotherapy and those who received placebo (25.0% and 24.3%, respectively; hazard ratio, 1.03; 95% CI, 0.82 to 1.29; P=0.81). Prednisolone therapy, as compared with placebo, was associated with significant reductions in the incidence of constrictive pericarditis (4.4% vs. 7.8%; hazard ratio, 0.56; 95% CI, 0.36 to 0.87; P=0.009) and hospitalization (20.7% vs. 25.2%; hazard ratio, 0.79; 95% CI, 0.63 to 0.99; P=0.04). Both prednisolone and M. indicus pranii, each as compared with placebo, were associated with a significant increase in the incidence of cancer (1.8% vs. 0.6%; hazard ratio, 3.27; 95% CI, 1.07 to 10.03; P=0.03, and 1.8% vs. 0.5%; hazard ratio, 3.69; 95% CI, 1.03 to 13.24; P=0.03, respectively), owing mainly to an increase in HIV-associated cancer.
In patients with tuberculous pericarditis, neither prednisolone nor M. indicus pranii had a significant effect on the composite of death, cardiac tamponade requiring pericardiocentesis, or constrictive pericarditis. (Funded by the Canadian Institutes of Health Research and others; IMPI ClinicalTrials.gov number, NCT00810849.).
Purpose
Detailed information on organization and process of care in intensive care units (ICU) in emerging countries is scarce. Here, we investigated the impact of organizational factors on the ...outcomes and resource use in a large sample of Brazilian ICUs.
Methods
Retrospective cohort study of 59,693 patients (medical admissions, 67 %) admitted to 78 ICUs during 2013. We retrieved patients’ data from an ICU quality registry and surveyed ICUs regarding structure, organization, staffing patterns, and process of care. We used multilevel logistic regression analysis to identify factors associated with hospital mortality. Efficient resource use was assessed by estimating standardized resource use and mortality rates adjusted for the SAPS 3 score.
Results
ICUs were mostly medical-surgical (79 %) and located at private hospitals (86 %). Median nurse to bed ratio was 0.20 (IQR, 0.15–0.28) and board-certified intensivists were present 24/7 in 16 (21 %) of ICUs. Multidisciplinary rounds occurred in 67 (86 %) and daily checklists were used in 36 (46 %) ICUs. Most frequent protocols focused on sepsis management and prevention of healthcare-associated infections. Hospital mortality was 14.4 %. In multivariable analysis, the number of protocols was the only organizational characteristic associated with mortality odds ratio = 0.944 (95 % CI 0.904–0.987). The effects of protocols were consistent across subgroups including surgical and medical patients as well as the SAPS 3 tertiles. We also observed a significant trend toward efficient resource use as the number of protocols increased.
Conclusions
In emerging countries such as Brazil, organizational factors, including the implementation of protocols, are potential targets to improve patient outcomes and resource use in ICUs.
The pathological hallmarks of multiple sclerosis (MS) lesions are inflammation, demyelination, axon loss and gliosis. The aim of this study was to verify the relation of brain lesion load and volume ...of the cerebral hemisphere determined by brain MRI with intrathecal antibody synthesis.
A longitudinal study of 54 Brazilian patients with the relapsing-remitting form of MS was undertaken after an average of 6.3 ± 2.7 years of treatment. MRI scans were performed, and cerebrospinal fluid samples were collected both during the diagnostic process and after treatment with β-interferon or glatiramer acetate.
A positive correlation between the IgG index and total lesion volume was identified. Intrathecal IgG against Epstein-Barr virus (EBV) was observed in 21 patients. The number of contrast-enhanced lesions observed in these patients was correlated with intrathecal IgM synthesis. Brain atrophy was observed early in the disease, with the number of relapses inversely correlated with brain volume.
The high intrathecal IgG synthesis observed in these relapsing-remitting MS patients is associated with the brain lesion burden and the presence of antibodies to EBV, whereas intrathecal IgM synthesis is associated with the activity of the disease, as revealed by MRI.
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