Resistance to antibiotics has made diseases that previously healed easily become more difficult to treat. Staphylococcus aureus is an important cause of hospital-acquired infections and multi-drug ...resistant. NorA efflux pump, present in bacteria S. aureus, is synthesized by the expression of the norA gene. Menadione, also known as vitamin K3, is one of the synthetic forms of vitamin K. Therefore, the aim of this study is to verify the menadione effect on efflux inhibition through NorA pump gene expression inhibition and assess the effects of menadione in bacterial membrane. The effect of menadione as an efflux pump inhibitor (EPI) was evaluated by the microdilution method, fluorimetry, electron microscopy, and by RT-qPCR to evaluate gene expression. In the molecular docking, association with menadione induces increased fluorescence intensity. Menadione was observed (100% of the clusters) interacting with residues ILE12, ILE15, PHE16, ILE19, PHE47, GLN51, ALA105, and MET109 from NorA. The results showed the norA gene had its expression significantly diminished in the presence of menadione. The simulation showed that several menadione molecules were able to go through the bilayer and allow the entry of water molecules into the hydrophobic regions of the bilayer. When present within membranes, menadione may have caused membrane structural changes resulting in a decline of the signaling pathways involved in norA expression. Menadione demonstrated to be an efflux pump inhibitor with dual mechanism: affecting the efflux pump by direct interaction with protein NorA and indirectly inhibiting the norA gene expression, possibly by affecting regulators present in the membrane altered by menadione.
Blood culture-negative infective endocarditis is a potentially severe disease that can be associated with infectious agents such as Bartonella spp., Coxiella burnetti, Tropheryma whipplei, and some ...fungi.
Reported here are two cases of blood culture-negative infective endocarditis in patients with severe aortic and mitral regurgitation in Brazil; the first case is a 47-year-old white man and the second is a 62-year-old white woman. Bartonella henselae deoxyribonucleic acid was detectable in the blood samples and cardiac valve with vegetation paraffin-fixed tissue samples. Additionally, an investigation was carried out on patients' pets, within the context of One Health, and serum samples collected from cats and dogs were reactive by indirect immunofluorescence assay.
Even though the frequency of bartonellosis in Brazil is unknown, physicians should be aware of the possibility of blood culture-negative infective endocarditis caused by Bartonella, particularly in patients with weight loss, kidney changes, and epidemiological history for domestic animals.
In Compost-Bedded Pack Barn (CBP) systems, air velocity is linked with the thermal comfort of housed dairy cattle and bedding quality and, therefore, assessing ventilation efficiency is essential. In ...this context, the objective of this study was to evaluate and characterize dependence and spatial distribution of air velocity at the 1.5 m height (vair,M) and at bedding level (vair,B) in an open CBP system with positive pressure ventilation. The study was conducted in 2021, in a facility located in the Zona da Mata region, Minas Gerais, Brazil. The facility area was divided into a mesh composed of 55 equidistant points, where vair,M and vair,B data were collected in the morning (09:00 a.m.) and afternoon (03:00 p.m.) periods, during three weeks in Brazilian winter. Geostatistics techniques were used to assess dependence and spatial distribution. In both periods evaluated, there were a strong occurrence of spatial dependence and non-uniform vair,M and vair,B distributions. The vair,M and vair,B values were lower than recommended (1.8 m∙s-1) in more than 65.0% of the area. Adequate ventilation levels were observed only in the first 20.0 m of the facility, from Southeast to Northwest, because of the fan lines present.
Thiazolidine compounds NJ20 {(E)-2-(2-(5-bromo-2-methoxybenzylidene)hydrazinyl)-4-(4-nitrophenyl)thiazole} and NW05 (2-(benzo (d) (1,3) dioxol-4-ylmethylene)-N-(4-bromophenyl)-thiosemicarbazone ...potentiated the effect of norfloxacin in resistant bacteria; however, there are no reports on their effects on
in the literature. The objective of this work was to evaluate the behavioral effects and oxidative markers of NW05 and NJ20 in lobster cockroach
. To evaluate the behavioral study, a video tracking software was used to evaluate the locomotor points and the exploratory profile of cockroaches in the horizontal and vertical regions of a new environment. The total concentration of thiol and reduced glutathione (GSH), substances reactive to thiobarbituric acid (TBARS), free iron (II) content and mitochondrial viability were determined. The antioxidant potential was evaluated by the DPPH method. Both substances induced changes in the behavior of cockroaches, showing a significant reduction in the total distance covered and in the speed. In the cell viability test (MTT), there was a significant reduction for NJ20 (1 mM). NJ20 caused a significant increase in total levels of thiol and non-protein thiol (NPSH), although it also slightly increased the content of malondialdehyde (MDA). Both compounds (NW05 and NJ20) caused a significant reduction in the content of free iron at a concentration of 10 mM. In conclusion, the compound NJ20 caused moderate neurotoxicity (1 mM), but had good antioxidant action, while NW05 did not show toxicity or significant antioxidant activity in the model organism tested. It is desirable to carry out complementary tests related to the antioxidant prospection of these same compounds, evaluating them at different concentrations.
Pressure ulcers frequently occur in patients with limited mobility, for example, people with advanced age and patients wearing casts or prostheses. Mobile information communication technologies can ...help implement ulcer care protocols and the monitoring of patients with high risk, thus preventing or improving these conditions. This article presents a mobile pressure ulcer monitoring platform (mULCER), which helps control a patient’s ulcer status during all stages of treatment. Beside its stand-alone version, it can be integrated with electronic health record systems as mULCER synchronizes ulcer data with any electronic health record system using HL7 standards. It serves as a tool to integrate nursing care among hospital departments and institutions. mULCER was experimented with in different mobile devices such as LG Optimus One P500, Samsung Galaxy Tab, HTC Magic, Samsung Galaxy S, and Samsung Galaxy i5700, taking into account the user’s experience of different screen sizes and processing characteristics.
Fungal pathologies caused by the genus Candida have increased in recent years due to the involvement of immunosuppressed people and the advance of resistance mechanisms acquired by these ...microorganisms. Liposomes are nanovesicles with lipid bilayers in which they store compounds. α-Bisabolol is a sesquiterpene with proven biological activities, and in this work it was tested alone in liposomes and in association with Fluconazole in vitro to evaluate the antifungal potential, Fluconazole optimization, and virulence inhibitory effect in vitro. Antifungal assays were performed against standard strains of Candida albicans, Candida tropicalis, and Candida krusei by microdilution to identify the IC50 values and to obtain the cell viability. The Minimum Fungicidal Concentration (MFC) was performed by subculturing on the solid medium, and at their subinhibitory concentration (Matrix Concentration (MC): 16,384 µg/mL) (MC/16), the compounds, both isolated and liposomal, were associated with fluconazole in order to verify the inhibitory effect of this junction. Tests to ascertain changes in morphology were performed in microculture chambers according to MC concentrations. Liposomes were characterized from the vesicle size, polydispersity index, average Zeta potential, and scanning electron microscopy. The IC50 value of the liposomal bisabolol associated with fluconazole (FCZ) was 2.5 µg/mL against all strains tested, revealing a potentiating effect. Liposomal bisabolol was able to potentiate the effect of fluconazole against the CA and CT strains by reducing its concentration and completely inhibiting fungal growth. α-Bisabolol in liposomal form inhibited the morphological transition in all strains tested at a concentration of MC/8. The liposomes were homogeneous, with vesicles with diameters of 203.8 nm for the liposomal bisabolol and a surface charge potential of −34.2 mV, conferring stability to the nanosystem. Through scanning microscopy, the spherical shapes of the vesicles were observed.
Background Intravenous thrombolysis (IVT) and endovascular therapy (EVT) were proven safe and effective for anterior circulation proximal occlusions. However, the most appropriate recanalization ...strategy in patients with acute basilar artery occlusion (BAO) is still controversial. This study aimed to assess outcomes of patients with BAO at an academic stroke center in Brazil. Methods This is a retrospective analysis of consecutive patients with BAO from a prospective stroke registry at Ribeirão Preto Medical School. Primary outcomes were mortality and favorable outcome (modified Rankin score mRS ≤3) at 90 days. After univariate analyses, multivariate logistic regressions were used to identify independent predictors of primary outcomes. Results Between August 2004 and December 2015, 63 (65% male) patients with BAO and median National Institutes of Health Stroke Scale (NIHSS) score of 31 (interquartile range: 19-36) were identified. Twenty-nine (46%) patients received no acute recanalization therapy, 15 (24%) received IVT, and 19 (30%) received EVT (68% treated with stent retrievers). Twenty-four (83%) patients treated conservatively died, and only 2 (7%) achieved an mRS less than or equal to 3. Among patients treated with acute recanalization therapies, 15 (44%) died, and 9 (26.5%) had a favorable outcome. On multivariate analysis, baseline systolic blood pressure (odds ratio OR = .97; 95% confidence interval CI: .95-0.99; P = .023), posterior circulation Alberta Stroke Program Early CT score (OR = .62; 95% CI: .41-0.94; P = .026), and successful recanalization (OR = .18; 95% CI: .04-0.71; P = .015) were independent predictors of lower mortality. Baseline NIHSS (OR = 1.40; 95% CI: 1.08-1.82; P = .012), prior use of statins (OR = .003; 95% CI: .001-0.28; P = .012), and successful recanalization (OR = .05; 95% CI: .001-0.27; P = .009) were independent predictors of favorable outcome. There was no significant difference between the IVT group and the EVT group on primary outcomes. Conclusions BAO is associated with high morbidity and mortality in Brazil. Access to acute recanalization therapies may decrease mortality in those patients.
Aims
Brazil is the eighth in number of suicides in the American continent, and 4th in the number of suicides in Latin America. From 2011–2016, there were 33,269 cases in women and 14,931 in men, with ...24.1% and 17.2% in populations aged 10–19 years, respectively. Regarding self-harm, there were 116,113 cases (25.9%), and 60,098 cases (19.6%). And in both, the recurrence rate was high, with 25.3–33.1%. Properly employed, the Singular Therapeutic Project (STP) can prevent further events and even completed suicide. In this way, there is a reduction in stigma in this population and for family members, adequacy of mental health services, in addition to lower public spending on hospitalizations. We analysed the effectiveness of the STP in cases of suicide attempt and self-harm, in an outpatient setting, through the comparison of a group of patients with more adherence with the STP, in relation to the group with less adherence in a multidisciplinary context.
Methods
It was a retrospective cohort, with adolescents aged 12 to 18 years, from the south of Sao Jose do Rio Preto (Brazil), during the period of 2015–2019, with follow-up for more than 3 months.
To analyze the behavior of numerical variables, descriptive statistics, boxplot plots and the specific test for Kolmogorov-Smirnov will be considered. Comparisons of continuous variables between two independent groups will be performed using Student's t test or Mann-Whitney test; comparisons of categorical variables with Pearson's chi-square test or Fisher's exact test.
Results
The study sample consisted of 88 patients, 79.5% of whom were girls, 1.1% were illiterate, 34.2% were referred from the health unit, 29.5% from the hospital emergency. Patients with new episodes of suicide attempts accounted for 14.7% (1 attempt −10.2%, 2–1.1%, 3–3.4%), and self-harm 23.8% (1–12.5%, 2–2.3%, 4–4.5%, 5–2.3%, 6–1.1%, 7–1.1%).
There was no statistical significance between the group with adherence to STP and without adherence in relation to new suicide attempts (p = 1.0) and recurrence of self-harm (p = 0.309). In addition, both outcomes were not statistically significant with sociodemographic data, psychoactive substance use, and negative life events.
Conclusion
The adolescents' adherence on STP was not associated in recurrence of suicide attempts and self-harm. We hypothesized that the sample size may have influenced the power of the statistical analysis. This pilot study is the first phase of the still ongoing study on all city.
Radiation-induced head and neck sarcoma (RIHNS) is a rare and serious long-term complication of radiotherapy (RT), with poor prognosis and high morbidity and mortality. Diagnosis is based on ...immunohistochemistry and molecular biomarker analysis, and therapy is usually surgical. Other adjuvant therapies might be considered. This case report aimed to describe the clinical, imaging, histopathological, and therapeutic characteristics of a rare case of RIHNS in the mandible after 21 years of RT. A 68-year-old male patient underwent a partial left parotidectomy in 1995, was diagnosed with pleomorphic adenoma, and after recurrence of the lesion in 2000, underwent an ipsilateral total parotidectomy with adjuvant RT. In May 2021, he complained of an ulcerated nodular lesion on the tongue that extended toward the lower gingiva, associated with oral bleeding and difficulties with swallowing. After biopsy in the gingival margin and histopathological analysis, the diagnosis of high-grade spindle-cell sarcoma was established. Complete surgical resection with microsurgical reconstruction using a fibular osteomusculocutaneous free flap was performed. RIHNS could appear after a period of almost 20 years after RT. Surgical resection with reconstructive surgery was a reliable and feasible therapeutic option that showed favorable clinical results after an appropriate follow-up.
The micronutrient vitamin A refers to a group of compounds with pleiotropic effects on human health. These molecules can modulate biological functions, including development, vision, and regulation ...of the intestinal barrier. The consequences of vitamin A deficiency and supplementation in children from developing countries have been explored for several years. These children live in an environment that is highly contaminated by enteropathogens, which can, in turn, influence vitamin A status. Vitamin A has been described to modulate gene expression, differentiation and function of diverse immune cells; however, the underlying mechanisms are not fully elucidated. This review aims to summarize the most updated advances on elucidating the vitamin A effects targeting intestinal immune and barrier functions, which may help in further understanding the burdens of malnutrition and enteric infections in children. Specifically, by covering both clinical and in vivo/in vitro data, we describe the effects of vitamin A related to gut immune tolerance/homeostasis, intestinal barrier integrity, and responses to enteropathogens in the context of the environmental enteric dysfunction. Some of the gaps in the literature that require further research are also highlighted.