Beyond pulmonary rehabilitation: can the PICk UP programme fill the gap? A randomised trial in COPD

INTRODUCTION AND OBJECTIVES

Pulmonary rehabilitation (PR) is a fundamental intervention to manage COPD, however, maintaining its benefits is challenging. Engaging in physical activity might help to prolong PR benefits. This study assessed the efficacy and effectiveness of a personalised community-based physical activity programme to sustain physical activity and other health-related PR benefits, in people with COPD.

MATERIALS AND METHODS

This was a multicentre, assessor blinded, randomised controlled trial. Following 12-weeks of PR, people with COPD were assigned to a six-months personalised community-based physical activity programme (experimental group), or to standard care (control group). Physical activity was assessed via: time spent in moderate to vigorous physical activities per day (primary outcome measure), steps/day and the brief physical activity assessment tool. Secondary outcomes included sedentary behaviour, functional status, peripheral muscle strength, balance, symptoms, emotional state, health-related quality of life, exacerbations and healthcare utilization. Assessments were performed immediately post-PR and after three- and six-months. Efficacy and effectiveness were evaluated using intention-to-treat and per-protocol analysis with linear mixed models.

RESULTS

Sixty-one participants (experimental group: n = 32; control group: n = 29), with balanced baseline characteristics between groups (69.6 ± 8.5 years old, 84 % male, FEV1 57.1 ± 16.7 %predicted) were included. Changes in all physical activity outcomes and in one-minute sit-to-stand were significantly different (P < 0.05) between groups at the six-month follow-up. In the remaining outcomes there were no differences between groups.

CONCLUSIONS

The community-based physical activity programme resulted in better physical activity levels and sit-to-stand performance, six-months after completing PR, in COPD. No additional benefits were observed for other secondary outcomes.

Endoscope channel drying, storage, and conditions after reprocessing: How safe are they in clinical practice?

INTRODUCTION AND AIMS

Adequate drying and proper storage of flexible endoscopes are essential for maintaining quality in their reprocessing. The aim of the present study was to evaluate the drying stages, storage, and channel conditions of endoscopes through borescope inspection.

MATERIAL AND METHODS

The personnel responsible for endoscope reprocessing were interviewed. Storage conditions at 10 endoscopy facilities were inspected and an internal examination of the channels and ports of the stored equipment was carried out, utilizing a borescope. A total of 74 stored endoscope channels were evaluated.

RESULTS

Only 10% of the facilities inspected utilized transport cases for storage and only 10% had rooms exclusively used for storage. Sixty percent of the facilities did not perform any shelf-life control. All the channels evaluated were scratched and fluids were present on 69% of them.

CONCLUSIONS

Endoscope reprocessing can be improved through the implementation of drying and storage control and validation tools, as well as the use of borescopes and periodic clinical audits.

Anethole supplementation during in vitro maturation increases in vitro goat embryo production in a concentration-dependent manner

During in vitro maturation (IVM) cumulus-oocyte complexes (COCs) are exposed to conditions that can trigger oxidative stress, thus, reducing oocyte maturation and viability. Aiming to mitigate these detrimental conditions, the effects of IVM medium supplementation with anethole have been tested. Anethole, also known as trans-anethole (1-methoxy-4 [1-propenyl]-benzene), is a naturally occurring phenylpropanoid with various pharmacological properties, including antioxidant effects. However, no study has examined anethole effect on goat COCs during IVM. Thus, the aim of this study was to evaluate the effects of different anethole concentrations on oocyte maturation, oxidative stress, and in vitro development of caprine embryos after parthenogenetic activation. Goat COCs were selected and randomly distributed into the following treatments: TCM-199+ medium (control), or TCM-199+ medium supplemented with 30 μg/mL (AN30); 300 μg/mL (AN300) or 2000 μg/mL (AN2000) of anethole. After IVM, part of the COCs was chosen for oocyte viability and chromatin configuration, intracellular reactive oxygen species levels, and mitochondrial membrane potential assessment. Another part of COCs was parthenogenetically activated, and presumptive zygotes were cultured for 7 days. Results demonstrated that anethole at 30 μg/mL increased oocyte maturation and cleavage rates when compared to the other treatments (P < 0.05), as well as oocyte viability and in vitro embryo production when compared to the control treatment (P < 0.05). Additionally, treatment with anethole at 2000 μg/mL decreased oocyte nuclear maturation and cleavage rates when compared to other treatments (P < 0.05) and embryo production if compared to control and AN30 treatments (P < 0.05). Moreover, anethole at 2000 μg/mL increased mitochondrial membrane potential when compared to the other treatments (P < 0.05). In conclusion, anethole exerts a concentration-dependent effect during goat COCs IVM. For a more desirable outcome of oocyte viability and maturation, and in vitro embryo production, the use of anethole at 30 μg/mL is recommended.

Clinical and Pathophysiologic Insights of Free triiodothyronine/Free thyroxine Ratio in Patients with Heart Failure with Preserved Ejection Fraction: Data from the NETDiamond Cohort

BACKGROUND

Thyroid dysfunction is common in patients with heart failure (HF). Impaired conversion of free T4 (FT4) into free T3 (FT3) is thought to occur in these patients, decreasing the availability of FT3 and contributing to HF progression. In HF with preserved ejection fraction (HFpEF), it is not known whether changes in conversion of thyroid hormones (THs) are associated with clinical status and outcomes.

OBJECTIVES

The objective of this study was to evaluate the association of FT3/FT4 ratio and TH with clinical, analytical, and echocardiographic parameters, as well as their prognostic impact in individuals with stable HFpEF.

METHODS

We evaluated 74 HFpEF participants of the NETDiamond cohort without known thyroid disease. We performed regression modeling to study the associations of TH and FT3/FT4 ratio with clinical, anthropometric, analytical, and echocardiographic parameters, and survival analysis to evaluate associations with the composite of diuretic intensification, urgent HF visit, HF hospitalization, or cardiovascular death over a median follow-up of 2.8 years.

RESULTS

The mean age was 73.7 years and 62% were men. The mean FT3/FT4 ratio was 2.63 (standard deviation: 0.43). Subjects with lower FT3/FT4 ratio were more likely to be obese and have atrial fibrillation. Lower FT3/FT4 ratio was associated with higher body fat (β = -5.60 kg per FT3/FT4 unit, p = 0.034), higher pulmonary arterial systolic pressure (PASP) (β = -10.26 mm Hg per FT3/FT4 unit, p = 0.002), and lower left ventricular ejection fraction (LVEF) (β = 3.60% per FT3/FT4 unit, p = 0.008). Lower FT3/FT4 ratio was associated with higher risk for the composite HF outcome (HR = 2.50, 95% CI: 1.04-5.88, per 1-unit decrease in FT3/FT4, p = 0.041).

CONCLUSIONS

In patients with HFpEF, lower FT3/FT4 ratio was associated with higher body fat, higher PASP, and lower LVEF. Lower FT3/FT4 predicted a higher risk of diuretic intensification, urgent HF visits, HF hospitalization, or cardiovascular death. These findings suggest that decreased FT4 to FT3 conversion might be a mechanism associated with HFpEF progression.

Changes in health-related quality of life and treatment effects in chronic heart failure: A meta-analysis

BACKGROUND

Heart failure (HF) is associated with poor health status, and high morbi-mortality. However, it is not well established how health status changes correlate with treatment effects on clinical outcomes. Our aim was to study the association between treatment-induced changes in health-status, assessed by Kansas City Cardiomyopathy Questionnaire 23 (KCCQ-23) and clinical outcomes in chronic HF.

METHODS

Systematic search of phase III-IV pharmacological RCTs in chronic HF that assessed KCCQ-23 changes and clinical outcomes throughout follow-up. We studied the association between treatment induced changes in KCCQ-23 and treatment effects on clinical outcomes (HF hospitalization or cardiovascular death, HF hospitalization, cardiovascular death, and all-cause death) using weighted random-effects meta-regression.

RESULTS

Sixteen trials were included, enrolling a total of 65,664 participants. Treatment induced KCCQ-23 changes were moderately correlated with treatment effects on the combined outcome of HF hospitalization or cardiovascular mortality (regression coefficient (RC) = -0.047, 95%CI: -0.085 to -0.009; R² = 49%), a correlation that was mainly driven by HF hospitalization (RC = -0.076, 95%CI: -0.124 to -0.029; R² = 56%). Correlations of treatment induced KCCQ-23 changes with cardiovascular death (RC = -0.029, 95%CI: -0.073 to 0.015; R² = 10%) and all-cause death (RC = -0.019, 95%CI: -0.057 to 0.019; R² = 0%) were weak and non-significant.

CONCLUSIONS

Treatment-induced changes in KCCQ-23 were moderately correlated with treatment-effects on HF hospitalizations but were not correlated with the effects on cardiovascular and all-cause mortality. Treatment-induced changes in patient-centered outcomes (i.e., KCCQ-23) may reflect non-fatal symptomatic changes in the clinical course of HF leading to hospitalization.

Moesziomyces spp. cultivation using cheese whey: new yeast extract-free media, β-galactosidase biosynthesis and mannosylerythritol lipids production

Mannosylerythritol lipids (MELs) are biosurfactants with excellent biochemical properties and a wide range of potential applications. However, high production costs, low productivity and unsatisfactory scale-up production have hampered commercial adoption. Herein, we report for the first time the β-galactosidase production by Moesziomyces spp. from different sugars (D-galactose, D-glucose and D-lactose), with D-galactose being the best β-galactosidase inducer, with 11.2 and 63.1 IU/mgbiomass, for Moesziomyces aphidis 5535 T and Moesziomyces antarcticus 5048 T, respectively. The production of this enzyme allows to break down D-lactose and thus to produce MEL directly from D-lactose or cheese whey (a cheese industry by-product). Remarkably, when CW was used as sole media component (carbon and mineral source), in combination with waste frying oil, MEL productivities were very close (1.40 and 1.31 gMEL/L/day) to the ones obtained with optimized medium containing yeast extract (1.92 and 1.50 gMEL/gsusbtrate), both for M. antarcticus and M. aphidis. The low-cost, facile and efficient process which generates large amounts of MELs potentiates its industrialization.

Supplementary Information

The online version contains supplementary material available at 10.1007/s13399-022-02837-y.

A real-life overview of a hematopoietic cell transplant program throughout a four-year period, including prospective registry, exclusion causes and final donor selection

Traceability of patients who are candidates for Hematopoietic cell transplant (HCT) is crucial to ensure HCT program quality. Continuous knowledge of both a detailed registry from a HCT program and final exclusion causes can contribute to promoting a real-life vision and optimizing patient and donor selection. We analyzed epidemiological data reported in a 4 year-monocentric prospective registry, which included all patients presented as candidates for autologous (Auto) and/or allogeneic (Allo) HCT. A total of 543 patients were considered for HCT: 252 (42.4%) for Allo and 291 (57.6%) for Auto. A total of 98 (38.9%) patients were excluded from AlloHCT due to basal disease progression more commonly (18.2%). Seventy-six (30.2%) patients had an HLA identical sibling, whereas 147 (58.3%) patients had only Haplo. UD research was performed in 106 (42%) cases, significantly more often in myeloid than lymphoid malignancies (57% vs 28.7%, p < 0.001) but 61.3% were finally canceled, due to donor or disease causes in 72.4%. With respect to Auto candidates, a total of 60 (20.6%) patients were finally excluded; progression was the most common cause (12%). Currently, Haplo is the most frequent donor type. The high cancellation rate of UD research should be revised to optimize further donor algorithms.

Sodium-glucose co-transporter inhibitors in insulin-treated diabetes: a meta-analysis

BACKGROUND

Patients with insulin-treated type 2 diabetes (T2D) have a high risk of major adverse cardiovascular events. Sodium-glucose cotransporter inhibitors (SGLTi) improve outcomes without hypoglycaemic risk.

AIMS

To study the effect of SGLTi in patients with T2D with and without background insulin treatment in outcome-driven RCTs.

METHODS

Random effects models.

RESULTS

A total of 54 374 patients with T2D were included in the analysis, of which 26 551 (48.8%) were treated with insulin. For 3P-MACE in patients without insulin treatment, the HR (95% CI) for the effect of SGLTi vs placebo was 0.93 (0.81-1.05), with moderate heterogeneity (I2 = 49.2%, Q statistic P = 0.11). In insulin-treated patients, the HR (95% CI) was 0.88 (0.82-0.95), without evidence of heterogeneity (I2 =0.0%, Q statistic P =0.91). The pooled effect evidenced a 10% reduction of 3P-MACE with SGLTi (HR: 0.90, 95% CI: 0.85-0.96), without SGLTi-by-insulin interaction P = 0.53. For the composite outcome of HF hospitalisation or cardiovascular death in patients without insulin treatment, the HR (95% CI) for the effect of SGLTi vs placebo was 0.77 (0.61-0.92), with marked heterogeneity (I2 = 66.8%, Q statistic P = 0.02). In insulin-treated patients, the HR (95% CI) was 0.77 (0.68-0.86), without significant heterogeneity (I2 = 31.7%, Q statistic P = 0.25). The pooled effect evidenced a 23% reduction of HF hospitalisations or cardiovascular death with SGLTi (HR: 0.77, 95% CI: 0.68-0.85), without SGLTi-by-insulin interaction P = 0.98.

CONCLUSION

SGLTi reduces cardiovascular events regardless of insulin use. However, the treatment effect is more homogeneous among insulin-treated patients, supporting the use of SGLTi for the treatment of patients with T2D requiring insulin for glycaemic control.

Crude glycerin in the supplementation of crossbred heifers in tropical pastures

Crude glycerin (CG) is a biodiesel byproduct that has been tested as an alternative feed additive for use in beef production. After being absorbed, it is used in the liver to produce glucose, an important precursor of intramuscular fat in ruminants. This study aimed to evaluate the effect of CG (439 g/kg glycerol) on the performance and meat quality of crossbred heifers finished in Urochloa brizantha cv. Marandu. Thirty-six heifers with an initial BW of 301.5 ± 23.02 kg were used. They were supplemented for 154 days with the following levels of CG: mineral mixture (without CG), 33.3, 66.6 and 99.9 g/kg CG in the DM of the supplement. Supplement or pasture DM intakes, slaughter BW and carcass traits were not influenced (P > 0.05) by increasing levels of CG. The total fat content of the meat, the vaccenic (18:1 n-7t) and conjugated linoleic acid (18:2 c9-t11) increased with the addition of CG in the diet (P < 0.05). Crude glycerin can be included up to 99.9 g/kg of the total diet without changing the performance of crossbred heifers finished in the tropical pasture.

Mitochondrial sequences of Rhipicephalus and Coxiella endosymbiont reveal evidence of lineages co-cladogenesis

Rhipicephalus ticks are competent vectors of several pathogens, such as Spotted Fever Group Rickettsiae (SFGR) and many Babesia species. Within this genus, different R. sanguineus s.l. lineages show an unequal vector competence and resistance regarding some pathogenic strains. Current literature supports that tick endosymbionts may play an essential role in the transmission ability of a vector. Indeed, the microbial community of Rhipicephalus seems to be dominated by Coxiella-like endosymbionts (CLE). Still, their co-evolutionary associations with the complicated phylogeny of Rhipicephalus lineages and their transmissible pathogens remain unclear. We performed a phylogenetic congruence analysis to address whether divergent R. sanguineus s.l. lineages had a different symbiont composition. For that, we applied a PCR based approach to screen part of the microbial community present in 279 Rhipicephalus ticks from the Iberian Peninsula and Africa. Our analyses detected several qPCR-positive signals for both SFGR and Babesia species, of which we suggest R. sanguineus-tropical lineage as a natural vector of Babesia vogeli and R. sanguineus-temperate lineage of SFGR. The acquisition of 190 CLE sequences allowed to evaluate co-phylogenetic associations between the tick and the symbiont. With this data, we observed a strong but incomplete co-cladogenesis between CLE strains and their Rhipicephalus tick lineages hosts.

Alkali-cation-incorporated and functionalized iron oxide nanoparticles for methyl blue removal/decomposition

Enhancing the rate of decomposition or removal of organic dye by designing novel nanostructures is a subject of intensive research aimed at improving waste-water treatment in the textile and pharmaceutical industries. Despite radical progress in this challenging area using iron-based nanostructures, enhancing stability and dye adsorption performance is highly desirable. In the present manuscript alkali cations are incorporated into iron oxide nanoparticles (IONPs) to tailor their structural and magnetic properties and to magnify methyl blue (MB) removal/decomposition capability. The process automatically functionalizes the IONPs without any additional steps. The plausible mechanisms proposed for IONPs incubated in alkali chloride and hydroxide solutions are based on structural investigation and correlated with the removal/adsorption capabilities. The MB adsorption kinetics of the incubated IONPs is elucidated by the pseudo second-order reaction model. Not only are the functional groups of -OH and -Cl attached to the surface of the NPs, the present investigation also reveals that the presence of alkali cations significantly influences the MB adsorption kinetics and correlates with the cation content and atomic polarizability.

Expression profiles of growth-related genes in two Nile tilapia strains and their crossbred provide insights into introgressive breeding effects

The Nile tilapia (Oreochromis niloticus) is a prominent farmed fish in aquaculture worldwide. Crossbreeding has recently been carried out between the Red-Stirling and the wt Chitralada strains of Nile tilapia, producing a heterotic hybrid (7/8 Chitralada and 1/8 Red-Stirling) that combines the superior growth performance of the Chitralada with the reddish coloration of the Red-Stirling strain. While classical selective breeding and crossbreeding strategies are well known, the molecular mechanisms underlying the phenotypic expression of economically advantageous traits in tilapia remain largely unknown. Molecular investigations have shown that variable expression of growth hormone (gh), insulin-like growth factors (igf1 and 2) and somatolactin (smtla) - components of the growth hormone/insulin-like growth factor (GH/IGF) axis - and myostatin (mstn) genes can affect traits of economic relevance in farmed animals. The aim of this study was to assess and compare the gene expression signature among Chitralada, Red-Stirling and their backcross hybrid in order to gain insights into the effects of introgressive breeding in modulation of the GH/IGF axis. Gene expression analyses in distinct tissues showed that most genes of the GH/IGF axis were up-regulated and mstn was down-regulated in backcross animals in comparison with Red-Stirling and Chitralada animals. These gene expression profiles revealed that backcross animals displayed a distinctive expression signature, which attests to the effectiveness of the introgressive breeding technique. Our findings also suggest that the GH/IGF axis and mstn genes might be candidate markers for fish performance and prove useful within genetic improvement programs aimed at the production of superior-quality tilapia strains using introgressive breeding.

The subtle balance of insulin and thyroxine on survival and development of in vitro cultured caprine preantral follicles enclosed in ovarian tissue

Numerous studies have reported the importance of thyroid hormones on the development of later preantral and antral follicles, but their interactions with other hormones and effects in regulating early preantral follicle growth remain unclear. Here we investigated the in vitro effects of thyroxine combined with insulin on caprine preantral follicle survival and development. Sliced ovarian tissues were cultured for 1 or 7 days using 10 ng/mL (low) or 10 μg/mL (high) insulin in the presence of thyroxine at 0, 0.5, 1 or 2 μg/mL. Post-culture, we evaluated the follicular survival and development, assessed the expression of apoptotic-related genes (Bcl2/Bax) and receptors of insulin and thyroid hormones, and quantified the estradiol and reactive oxygen species (ROS) production levels. Follicular survival in low-insulin culture conditions was enhanced by the presence of 0.5 μg/mL thyroxine (P < 0.05) as compared to the thyroxine-free medium but remained similar to non-cultured control in the presence of 2 μg/mL (P > 0.05). Significantly higher ROS production was measured from Day 1 to Day 7 in low-insulin culture media containing 0.5 or 2 μg/mL thyroxine (P < 0.05). When compared to high insulin level, the presence of thyroxine in low insulin culture conditions yielded higher stromal cell density (P < 0.05), increased estradiol production on Day 1, and higher Bcl2/Bax ratio on Day 7. Cultures with high levels of both insulin and thyroxine led to follicles and oocytes with larger diameters (P < 0.05). The RNA transcript levels of insulin and thyroid receptors were reduced in the presence of high insulin cultures when compared to controls (non-cultured). In conclusion, the combination of low concentrations of insulin and thyroxine better maintained follicle survival, while high levels ensured better follicular development.

Scenedesmus obliquus in poultry wastewater bioremediation

Wastewater biological treatment with microalgae can be an effective technology, removing nutrients and other contaminants while reducing chemical oxygen demand. This can be particularly interesting for the meat producing industry which produces large volumes of wastewater from the slaughtering of animals and cleaning of their facilities. The main purpose of this research was the treatment of poultry wastewater using Scenedesmus obliquus in an economical and environmentally sustainable way. Two wastewaters were collected from a Portuguese poultry slaughterhouse (poultry raw - PR and poultry flocculated - PF) and the bioremediation was evaluated. The performance of microalga biomass growth and biochemical composition were assessed for two illumination sources (fluorescent vs LEDs). S. obliquus achieved positive results when grown in highly contaminated agro-industrial wastewater from the poultry industry, independently of the light source. The wastewater bioremediation revealed results higher than 97% for both ammonium and phosphate removal efficiency, for a cultivation time of 13 days. The saponifiable matter obtained from the biomass of the microalga cultures was, on average, 11% and 27% (m/m_alga) with PR and PF wastewater, respectively. In opposition, higher sugar content was obtained from microalgae biomass grown in PR wastewater (average 34% m/m_alga) in comparison to PF wastewater (average 23% m/m_alga), independently of the illumination source. Therefore, biomass obtained with PR wastewater will be more appropriate as a raw material for bioethanol/biohydrogen production (higher sugar content) while biomass produced in PF wastewater will have a similar potential as feedstock for both biodiesel and bioethanol/biohydrogen production (similar lipid and sugar content).

Effects of cottonseed oil and ferrous sulfate on the performance and expression of antioxidant enzymes in broilers

Aiming to reduce feed costs, cottonseed oil (CSO) has been used as an alternative component in diets for broilers. However, this oil contains gossypol, an antinutritional agent that impacts the use of mineral elements, inhibits glucose uptake, and has a direct inhibitory action on intestinal enzymes. Nevertheless, toxic effects of gossypol can be prevented by the addition of iron salts, such as ferrous sulfate (FS), to the diet. This work was conducted to evaluate performance and gene expression of the antioxidant enzymes superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) in the intestines of 21- and 42-day-old broilers fed 0, 2, 4, or 6% concentrations of CSO, with or without FS. All CSO diets led to weight gain (WG) at 21 D. At 42 D, an increase in WG and a decrease in feed conversion (FCR) in the diets containing FS were observed. In 21-day-old birds supplemented with 4% CSO and FS, an increase in GPx gene expression was observed when compared to the 6% level. Animals (42 day old) supplemented with 6% CSO and FS presented greater expression of SOD gene when compared to 2% CSO and FS. In addition, a higher GPx expression in broilers supplemented with 6% CSO and FS compared to 6% CSO without FS was achieved. In conclusion, including CSO in the diets of broiler favors WG in animals at 21 D of age, independent of the presence or absence of FS; and including 4% CSO and FS in the diet of these animals alters the expression of the GPx gene in the intestine, so it is not necessary to add FS at 21 D. On the other hand, in 42-day-old broilers, the addition of FS is indicated, due to increases WG, decreased FCR and at the 6% CSO level without FS increase in the expression of the SOD and GPx genes.

Multimodal strategy to improve the adherence to hand hygiene and self-assessment of the institution for the promotion and practice of hand hygiene

Background

Hand hygiene (HH) has a low rate of adherence worldwide. This study aimed to estimate the HH adherence rate before and after the implementation of the multimodal strategy and to perform a self-assessment of an institution for promotion and practice of HH.

Methods

Before and after study, conducted in a university hospital. Professionals of the medical and nursing staff were included. Data collection was from October 2013 to July 2015, through observations of the HH opportunities and application of the HH self-assessment instrument for the institution. Descriptive and univariate analysis were performed.

Results

A total of 9500 HH opportunities were observed. The rate of adherence to HH in pre-intervention period was 20.8%, compared to 16.2% and 15.7% in post-intervention. Regarding the evaluation of the institution, it did not have an established ongoing program of training of professionals, no feedback of HH rates to professionals.

Conclusion

The low rate of HH adherence reflected the evaluation of the institution in relation to its investment in the practice and promotion of HH, showing that the investment policy for HH adherence needs to be reviewed, considering that before the study the hospital has not been trained in the 'My Five Moments for HH'.

Serological and molecular evidence of Bartonella henselae in cats from Luanda city, Angola

A total of 100 domestic cats from Luanda (Angola) were tested for the presence of antibodies against Bartonella henselae and spotted fever group of Rickettsia (SFGR) using indirect immunofluorescence assay (IFA). Molecular screening targeting the riboflavin synthase (ribC) gene for Bartonella and outer membrane protein B (ompB) gene for Rickettsia, using conventional PCR and sequencing was also performed in cat´s blood samples. Sixty-six percent of the cats from Luanda had IgG antibodies against Bartonella species but none of them had antibodies against SFGR. Of the total seroreactive cats for Bartonella henselae, 4.5% had an IgG titre of 64 (cut-off), 60.6% a titre of 128, 28.8% a titre of 256 and 6.1% a titre of 512. A statistically significant association was observed between seropositivity for Bartonella henselae and the lack of access to prophylaxis against ectoparasites (p = 0.018). Molecular detection and further sequence analysis of the positive amplicons allowed identification of Bartonella henselae in a 2-year old male cat. To the best of our knowledge this study confirms for the first time, the presence of Bartonela henselae circulating in domestic cats from Luanda. This fact call the attention for the possible cases of cat-scratch disease in humans.

Behavioral disorders and impairment of quality of life in children and adolescents with lower urinary tract dysfunction

BACKGROUND

Lower urinary tract dysfunction (LUTD) is a broad term describing the full spectrum of disorders in any of the stages of bladder function-storage or voiding LUTD is a clinical condition associated with emotional and behavioral disorders in children. This cross-sectional study aimed to investigate the association of emotional and behavioral symptoms and their impact on the quality of life (QoL) in children and adolescents with LUTD.

METHODS

Eighty-eight patients and their parents enrolled in an interdisciplinary program for children and adolescents with LUTD were included in the analysis. Child Behavior Checklist (CBCL) was used to estimate the prevalence of behavioral and emotional problems through the assessment of 14 items. Pediatric Quality of Life Inventory (versions for parents and children) was applied in the versions for parents and children to evaluate the QoL. The Pediatric Quality of Life Inventory-PedsQL, version 4.0-was applied separately for parents and patients. The association of clinical variables and aspects related to QoL of patients were evaluated through non-parametric correlations (Spearman) and multiple linear regression analysis.

RESULTS

According to CBCL's clinical scores, 56% of the patients showed total behavioral problems, 55% internalizing, and 38% externalizing. When comparing the conditions of LUTD and the CBCL scores, patients with voiding postponement had the lowest rates of total problems (P = 0.036). Children and adolescents with LUTD who also had enuresis showed a higher frequency of externalizing problems (P = 0.001), especially aggressive behavior (P = 0.013). Scores of patients with LUTD were significantly lower in all domains of QoL than normative data. Presence of behavioral problems was associated with worse QoL in all evaluated aspects. The total QoL was most influenced by the CBCL school competence scale according to the regression model analysis.

CONCLUSIONS

The study findings suggest the relevance of evaluation of behavioral and social repercussions of LUTD to improve the multidisciplinary approach for this condition in pediatric population.

Hereditary angioedema with C1 inhibitor (C1-INH) deficit: the strength of recognition (51 cases)

Hereditary angioedema (HAE) is a rare autosomal dominant disease due to C1 esterase inhibitor deficiency (C1-INH). The disease is characterized by subcutaneous and submucosal edema in the absence of urticaria due to the accumulation of bradykinin. This descriptive study aimed to evaluate the clinical characteristics of patients with a confirmed diagnosis of HAE referred to our Outpatient Clinic between December 2009 and November 2017. Fifty-one patients (38 F, 13 M) with a mean age of 32 years (range: 7–70 y) were included. Family history of HAE was reported in 70% (36/51) of the cases; 33/46 patients became symptomatic by 18 years of age. The median time between onset of symptoms and diagnosis was 13 years (3 mo–50 y). The most frequent triggering factors for attacks were stress (74.4%), trauma (56.4%), and hormonal variations (56%). The main symptoms were subcutaneous edema in 93.5% (43/46) of patients, gastrointestinal symptoms in 84.8% (39/46), and obstruction in the upper airways in 34.8% (16/46). Hospitalization occurred in 65.2%, of whom 13.3% had to be transferred to the Intensive Care Unit. Prophylactic treatment was instituted in 87% (40/46) of patients, and 56.5% (26/46) required additional treatment to control attacks. Owing to our data collection over a period of 8 years, a significant number of patients were identified by this HAE reference center. Despite early recognition and prophylactic treatment, a high percentage of patients were hospitalized. HAE is still diagnosed late, reinforcing the need for more reference centers specialized in diagnosis and educational projects for health professionals.

Essential oil of Pterodon polygalaeflorus Benth attenuates nociception in mice

Essential oils (EO) are volatile liquids responsible for the aroma of plants. Pterodon polygalaeflorus seeds have received widespread use in folk medicine for the treatment of inflammatory diseases. For this reason and because Pterodon polygalaeflorus seeds have great EO content, which is frequently pharmacologically active, the present study aimed to evaluate the antinociceptive effect of EO from Pterodon polygalaeflorus (EOPPgfl) and its acute toxic effects. The EEOPPgfl sample, which was extracted by steam distillation of the seeds, had a yield of 2.4% of the seeds weight and had, as major constituents, beta-elemene (48.19%), trans-caryophyllene (19.51%), and epi-bicyclosesquiphellandrene (12.24%). The EOPPgfl sample showed mild acute toxicity and its calculated median lethal dose (LD₅₀) was 3.38 g/kg. EOPPgfl (20–60 mg/kg) showed antinociceptive activity as evidenced by several tests and inhibited writhing induced by acetic acid. The maximum effect was obtained with the 30 mg/kg dose and at 60 min after its administration. EOPPgfl also decreased formalin-induced nociception, as verified by the inhibition of the first and second phase of the formalin test. At 30 mg/kg, EOPPgfl also decreased thermally stimulated nociception. Nociception may be related to inflammatory and antiedematogenic activity and at doses ranging 10–100 mg/kg, EOPPgfl blocked dextran- and carrageenan-induced edema. The results demonstrated that EOPPgfl presented, at doses approximately 100 times smaller than LD₅₀, an antinociceptive effect that probably was due to anti-inflammatory activities.

Combining biotechnology with circular bioeconomy: From poultry, swine, cattle, brewery, dairy and urban wastewaters to biohydrogen

The ability of microalgae to grow in nutrient-rich environments and to accumulate nutrients from wastewaters (WW) makes them attractive for the sustainable and low-cost treatment of WW. The valuable biomass produced can be further used for the generation of bioenergy, animal feed, fertilizers, and biopolymers, among others. In this study, Scenedesmus obliquus was able to remove nutrients from different wastewaters (poultry, swine and cattle breeding, brewery and dairy industries, and urban) with removal ranges of 95-100% for nitrogen, 63-99% for phosphorus and 48-70% for chemical oxygen demand. The biomass productivity using wastewaters was higher (except for poultry) than in synthetic medium (Bristol), the highest value being obtained in brewery wastewater (1025 mg/(L.day) of freeze-dried biomass). The produced biomass contained 31-53% of proteins, 12-36% of sugars and 8-23% of lipids, regardless of the type of wastewater. The potential of the produced Scenedesmus obliquus biomass for the generation of BioH₂ through batch dark fermentation processes with Enterobacter aerogenes was evaluated. The obtained yields ranged, in mL H₂/g Volatile Solids (VS), from 50.1 for biomass from anaerobically digested cattle WW to 390 for swine WW, whereas the yield with biomass cultivated in Bristol medium was 57.6 mL H₂/g_VS.

Low prevalence of relevant findings in inappropriate echocardiograms and discordant perceptions between cardiologists and patients

Complementary examinations are "inadequate" whenever the likelihood of benefits from their indication is lower than the negative results. The low benefit is a result of poor performance in detecting relevant changes that lead to improved behavior. However, inadequate examinations are prevalent and little is known about patients' notions of the usefulness of such indications. The aim of this study was to describe relevant findings in inappropriate echocardiograms and to assess the level of agreement between patients and cardiologists regarding their usefulness. Adults without known cardiovascular disease who were referred for echocardiogram by inappropriate criteria according to the American College of Cardiology were selected. Relevant findings were defined by any change in the degree of moderate to severe, according to the American Society of Echocardiography. We tested the level of agreement between the patients who underwent echocardiographic examination and the physicians who requested the exam through a standard questionnaire. Five hundred patients were included, with average age of 52±17 years (47% males). Only 17 patients had any relevant changes (3.4%, 95%CI=2 to 5.4%). The most frequent alterations included valve changes in 8 and diastolic dysfunction grade II in 6 patients. Eighty-seven examinations were performed to determine the level of agreement between patients and cardiologists. For the question "Is this test really necessary?", 92% of patients responded positively, compared with 5% of cardiologists (Kappa negative 0.04; P=0.01). The frequency of relevant findings was low in inadequate echocardiograms and patients and cardiologists had a different perception regarding its usefulness.

Phylogenetic insights on Mediterranean and Afrotropical Rhipicephalus species (Acari: Ixodida) based on mitochondrial DNA

A multigene phylogeny including 24 Rhipicephalus species from the Afrotropical and Mediterranean regions, based on mitochondrial DNA genes (COI, 12S and 16S), was constructed based on Bayesian inference and maximum likelihood estimations. The phylogenetic reconstruction revealed 31 Rhipicephalus clades, which include the first molecular records of Rhipicephalus duttoni (Neumann), and Rhipicephalus senegalensis (Koch). Our results support the R. pulchellus, R. evertsi and R. pravus complexes as more phylogenetically close to Rhipicephalus (Boophilus) than to the remaining Rhipicephalus clades, suggesting two main monophyletic groups within the genus. Additionally, the phenotypic resembling R. sanguineus s.l. and Rhipicephalus turanicus (Pomerantsev) are here represented by nine clades, of which none of the R. turanicus assemblages appeared as distributed in the Iberian Peninsula. These results not only indicate that both species include more cryptic diversity than the already reported, but also suggest that R. turanicus distribution is less extended than previously anticipated. This analysis allowed to improve species identification by exposing cryptic species and reinforced mtDNA markers suitability for intra/inter-species clarification analyses. Incorporating new species molecular records to improve phylogenetic clarification can significantly improve ticks' identification methods which will have epidemiologic implications on public health.

Molecular detection of Anaplasma bovis, Ehrlichia canis and Hepatozoon felis in cats from Luanda, Angola

Background

Molecular identification of tick-borne pathogen infection in cats from Africa is scarce. The presence of bacterial (Anaplasma and Ehrlichia) and protozoal (Babesia and Hepatozoon) agents was investigated in blood samples from 102 domestic cats from Luanda, Angola, by polymerase chain reaction and DNA sequencing.

Results

Three cats (2.9%) were found infected with Ehrlichia canis, three (2.9%) with Hepatozoon felis and one (1.0%) with Anaplasma bovis. The prevalence of infections with one single agent was 4.9%, and that of infection with two agents (i.e. E. canis and H. felis) was 1.0%. In total, six cats (5.9%) were found infected with at least one of the detected tick-borne agents.

Conclusions

This is the first report of A. bovis, E. canis and H. felis in cats from Angola. To the best of our knowledge, A. bovis is also being reported for the first time in domestic cats outside of Japan. Cats are at a low to moderate risk of being infected with tick-borne agents in Luanda.

Electronic supplementary material

The online version of this article (10.1186/s13071-018-2767-y) contains supplementary material, which is available to authorized users.

Serological and molecular detection of spotted fever group Rickettsia in a group of pet dogs from Luanda, Angola

Background

Infections with tick-borne rickettsiae can cause diseases well known in humans but still not so well characterized in dogs. Susceptibility to infection depends on the virulence of Rickettsia spp. and only a few of them have been described to cause disease in dogs. The aim of this study was to investigate the exposure to Rickettsia spp. among a group of pet dogs from Luanda, Angola.

Results

Out of 103 dogs included in the study, 62 (60.2%) were infested with ticks. Plasma specimens tested for serology by an immunofluorescence assay (IFA) revealed that six (5.8%) dogs had detectable immunoglobulin G (IgG) antibodies to spotted fever group Rickettsia (SFGR), with endpoint titers of 64 for two dogs, 128 for three dogs and 1024 for one dog. From the seropositive group of dogs, five (83%) of them were males, with their age ranging from 1 to 8 years old. Among the seropositive dogs, four (66.7%) were parasitized with ticks and no breed (or cross) was found to be associated with specific antibodies. Rickettsia spp. DNA was detected by nested-polymerase chain reaction (PCR) in two (1.9%) dogs that were found to be seronegative.

Conclusions

Seroprevalence and molecular detection of Rickettsia spp. infection in this group of pet dogs from Luanda is low compared with other studies performed in the same type of hosts in other areas. Although many dogs were parasitized with ticks, a low prevalence of Rickettsia spp. could be related with the hypothesis of a low rickettsial prevalence in the infesting ticks. This study provides evidence that dogs in Luanda are exposed to Rickettsia spp., but further studies are needed to better characterize the bacterial infections in dogs and in their ectoparasites.

Development and Assessment of an E-learning Course on Pediatric Cardiology Basics

BACKGROUND

Early detection of congenital heart disease is a worldwide problem. This is more critical in developing countries, where shortage of professional specialists and structural health care problems are a constant. E-learning has the potential to improve capacity, by overcoming distance barriers and by its ability to adapt to the reduced time of health professionals.

OBJECTIVE

The study aimed to develop an e-learning pediatric cardiology basics course and evaluate its pedagogical impact and user satisfaction.

METHODS

The sample consisted of 62 health professionals, including doctors, nurses, and medical students, from 20 hospitals linked via a telemedicine network in Northeast Brazil. The course was developed using Moodle (Modular Object Oriented Dynamic Learning Environment; Moodle Pty Ltd, Perth, Australia) and contents adapted from a book on this topic. Pedagogical impact evaluation used a pre and posttest approach. User satisfaction was evaluated using Wang's questionnaire.

RESULTS

Pedagogical impact results revealed differences in knowledge assessment before and after the course (Z=-4.788; P<.001). Questionnaire results indicated high satisfaction values (Mean=87%; SD=12%; minimum=67%; maximum=100%). Course adherence was high (79%); however, the withdrawal exhibited a value of 39%, with the highest rate in the early chapters. Knowledge gain revealed significant differences according to the profession (X22=8.6; P=.01) and specialty (X22=8.4; P=.04). Time dedication to the course was significantly different between specialties (X22=8.2; P=.04).

CONCLUSIONS

The main contributions of this study are the creation of an asynchronous e-learning course on Moodle and the evaluation of its impact, confirming that e-learning is a viable tool to improve training in neonatal congenital heart diseases.

Molecular investigation of tick-borne pathogens in dogs from Luanda, Angola

BACKGROUND

No molecular data have been available on tick-borne pathogens that infect dogs from Angola. The occurrence of agents from the genera Anaplasma, Babesia, Ehrlichia and Hepatozoon was assessed in 103 domestic dogs from Luanda, by means of the polymerase chain reaction (PCR) and DNA sequence analysis.

RESULTS

Forty-six dogs (44.7 %) were positive for at least one pathogen. Twenty-one animals (20.4 %) were found infected with Anaplasma platys, 18 (17.5 %) with Hepatozoon canis, six (5.8 %) with Ehrlichia canis, six (5.8 %) with Babesia vogeli, one (1.0 %) with Babesia gibsoni and one (1.0 %) with an unnamed Babesia sp. The molecular frequency of single infections taken together was 37.9 % and that of co-infections with several combinations of two pathogens accounted for 6.8 % of the animals.

CONCLUSIONS

This is the first report of A. platys, B. vogeli, B. gibsoni, E. canis and H. canis infections diagnosed by PCR in domestic dogs from Angola. The present study provides evidence that dogs in Luanda are widely exposed to, and at risk of becoming infected with, tick-borne pathogens. Further investigation is needed, including a larger number of animals, canine populations from other cities and provinces of the country, as well as potential vector ticks, aiming at better characterizing and controlling canine vector-borne diseases in Angola.

A biophysical characterization of the interaction of a hepatitis C virus membranotropic peptide with micelles

Membrane fusion is a highly regulated process that allows enveloped viruses to enter cells and replicate. Viral glycoproteins trigger membrane fusion by means of internal sequences known as fusion peptides. The hepatitis C virus (HCV) genome encodes the envelope glycoproteins E1 and E2, but their specific roles in the fusion step and the localization of the fusion peptide remain uncharacterized. Here, we studied the biophysics of the interactions between the glycoprotein E2 peptide HCV421-445 and four different micellar systems providing ionic, non-ionic and zwitterionic surfaces to investigate the importance of electrostatic interactions for peptide-membrane binding. Circular dichroism, fluorescence spectroscopy and calorimetry were used to characterize peptide-micelle interactions and structural changes. Fluorescence quenching showed that HCV421-445 interacts with SDS or CTAB ionic, n-OGP non-ionic and DPC zwitterionic micelles. The indole ring of Trp seems to anchor the peptide in micelles. Trp residues seem to be more deeply inserted in ionic and non-ionic micelles where peptide interactions are more stable than with DPC zwitterionic micelles. The interaction with zwitterionic micelles appears to occur at the surface. Both interaction types are exothermic because of peptide-micelle interactions and a gain of secondary structure in the helical conformation. HCV421-445 interacts with detergent monomers and micelles. Peptide-micelle interaction is pH-independent. HCV421-445 interacts with membranes, promoting aggregation and coalescence of vesicles with content leakage, suggesting that HCV421-445 may participate in membrane fusion. This structural characterization contributes to our understanding of the molecular process that promotes fusion, which is important in the further development of new antiviral therapies.

A Dual Role for P2X7 Receptor during Porphyromonas gingivalis Infection

Emerging evidence suggests a role for purinergic signaling in the activation of multiprotein intracellular complexes called inflammasomes, which control the release of potent inflammatory cytokines, such as interleukin (IL) -1β and -18. Porphyromonas gingivalis is intimately associated with periodontitis and is currently considered one of the pathogens that can subvert the immune system by limiting the activation of the NLRP3 inflammasome. We recently showed that P. gingivalis can dampen eATP-induced IL-1β secretion by means of its fimbriae in a purinergic P2X7 receptor-dependent manner. Here, we further explore the role of this purinergic receptor during eATP-induced IL-1β processing and secretion by P. gingivalis-infected macrophages. We found that NLRP3 was necessary for eATP-induced IL-1β secretion as well as for caspase 1 activation irrespective of P. gingivalis fimbriae. Additionally, although the secretion of IL-1β from P. gingivalis-infected macrophages was dependent on NLRP3, its adaptor protein ASC, or caspase 1, the cleavage of intracellular pro-IL-1β to the mature form was found to occur independently of NLRP3, its adaptor protein ASC, or caspase 1. Our in vitro findings revealed that P2X7 receptor has a dual role, being critical not only for eATP-induced IL-1β secretion but also for intracellular pro-IL-1β processing. These results were relevant in vivo since P2X7 receptor expression was upregulated in a P. gingivalis oral infection model, and reduced IFN-γ and IL-17 were detected in draining lymph node cells from P2rx7(-/-) mice. Furthermore, we demonstrated that P2X7 receptor and NLRP3 transcription were modulated in human chronic periodontitis. Overall, we conclude that the P2X7 receptor has a role in periodontal immunopathogenesis and suggest that targeting of the P2X7/NLRP3 pathway should be considered in future therapeutic interventions in periodontitis.

Sequential keratinocytic differentiation and maturation in a three-dimensional model of human artificial oral mucosa

BACKGROUND AND OBJECTIVE

Oral mucosa shortage may limit or condition some clinical approaches in maxillofacial, periodontal and implant treatment. The availability of a human oral mucosa model generated by tissue engineering could help clinicians to address the lack of oral mucosa. In this work, we carried out a sequential maturation and differentiation study of the epithelial cell layer of an artificial human oral mucosa substitute based on fibrin-agarose biomaterials with fibroblasts and keratinocytes.

MATERIAL AND METHODS

Histological, immunohistochemical and gene expression analyses were carried out in artificial human oral mucosa models developed and cultured for 1, 2 and 3 wk.

RESULTS

Artificial oral mucosa models showed expression of tight junction proteins and cytokeratins from the first week of in vitro development. Mature samples of 3 wk of development subjected to air-liquid conditions showed signs of epithelial differentiation and expressed specific RNAs and proteins corresponding to adherent and gap junctions and basement lamina. Moreover, these mature samples overexpressed some desmosomal and tight junction transcripts, with gap junction components being downregulated.

CONCLUSION

These results suggest that bioengineered human oral mucosa substitutes form a well-developed epithelial layer that was very similar to human native tissues. In consequence, the epithelial layer could be fully functional in these oral mucosa substitutes, thus implying that these tissues may have clinical usefulness.

Toxoplasmosis in dogs: first report of Toxoplasma gondii infection in any animal species in Angola

Despite the worldwide importance of zoonotic parasite Toxoplasma gondii, nothing is known of toxoplasmosis in animals in Angola. The present study aimed at estimating the seroprevalence and also at assessing correlates of T. gondii infection in pet dogs from Luanda, Angola. Dogs (n = 103) brought to a veterinary clinic in the city of Luanda were investigated. Serum samples were tested for antibodies to T. gondii with a modified agglutination test (MAT) commercial kit, at serial dilutions of 1∶20 to 1∶160. In accordance with the established cutoff value (MAT ≧20), 16 dogs [15·5%; 95% confidence interval (CI): 9·2-24·0%] had antibodies to T. gondii: 10 had a titer of 20, two had a titer of 40, and four had a titer of 80. Age (≧12 months) was found to be a risk factor for infection [odds ratio (OR) = 9·23; 95% CI: 1·16-73·27). For each 1-year increase in age, the risk of a dog being found seropositive significantly increased by an OR of 1·18 (95% CI: 1·02-1·36). The present study, which represents the first serological survey of T. gondii in any animal species from Angola, reveals a 15·5% seroprevalence of infection in pet dogs in Luanda. Further studies are needed to better understand the epidemiology of zoonotic T. gondii infection in Luanda and also in Angola.

What is new in genetics and osteogenesis imperfecta classification?

OBJECTIVE

Literature review of new genes related to osteogenesis imperfecta (OI) and update of its classification.

SOURCES

Literature review in the PubMed and OMIM databases, followed by selection of relevant references.

SUMMARY OF THE FINDINGS

In 1979, Sillence et al. developed a classification of OI subtypes based on clinical features and disease severity: OI type I, mild, common, with blue sclera; OI type II, perinatal lethal form; OI type III, severe and progressively deforming, with normal sclera; and OI type IV, moderate severity with normal sclera. Approximately 90% of individuals with OI are heterozygous for mutations in the COL1A1 and COL1A2 genes, with dominant pattern of inheritance or sporadic mutations. After 2006, mutations were identified in the CRTAP, FKBP10, LEPRE1, PLOD2, PPIB, SERPINF1, SERPINH1, SP7, WNT1, BMP1, and TMEM38B genes, associated with recessive OI and mutation in the IFITM5 gene associated with dominant OI. Mutations in PLS3 were recently identified in families with osteoporosis and fractures, with X-linked inheritance pattern. In addition to the genetic complexity of the molecular basis of OI, extensive phenotypic variability resulting from individual loci has also been documented.

CONCLUSIONS

Considering the discovery of new genes and limited genotype-phenotype correlation, the use of next-generation sequencing tools has become useful in molecular studies of OI cases. The recommendation of the Nosology Group of the International Society of Skeletal Dysplasias is to maintain the classification of Sillence as the prototypical form, universally accepted to classify the degree of severity in OI, while maintaining it free from direct molecular reference.

First Report of Anthracnose Caused by Colletotrichum spaethianum on Hemerocallis flava in Brazil

In January 2011, leaves of several daylily (Hemerocallis flava L.) plants in nurseries in Vitória da Conquista, northeastern Brazil, showed typical anthracnose symptoms. Reddish brown lesions with a yellow halo were first observed at the tip leaves. As the disease progressed, the lesions rapidly expanded down the leaves, resulting in severe blight. Small pieces up to 5 mm in diameter were removed from the lesion margins, surface sterilized for 1 min in 1.5% NaOCl, washed twice with sterile distilled water, and plated onto potato dextrose agar (PDA) amended with 0.5 g liter^-1 streptomycin sulfate. Macroscopic colony characters and microscopic morphology characteristics of two isolates were developed after growth on PDA for 7 days at 25°C under a 12-h light/dark cycle. Colonies presented effuse mycelium, initially white and becoming pale gray, with numerous black structures like sclerotia, setae, and acervuli absent in culture media. Conidia were hyaline, aseptate, curved or slightly curved, round or somewhat acute apex, base truncate, 13.4 to 22.7 (18.2 ± 2.16) μm length, and 3.2 to 5.8 (4.24 ± 0.62) μm width, length/width ratio 4.37, and were typical of Colletotrichum spp. DNA sequencing of partial sequence of actin (ACT), chitin synthase (CHS-1), and glyceraldehyde-3-phosphate dehydrogenase (GPD) genes and the internal transcribed spacer (ITS1-5.8S-ITS2 rRNA gene cluster) were conducted to accurately identify the species. Sequences of two daylily isolates were highly similar to those of C. spaethianum (Allesch.) Damm, P.F. Cannon & Crous. A phylogenetic analysis using Bayesian inference and including published ACT, CHS-1, GPDH, and ITS data for C. spaethianum and other Colletotrichum species associated with daylily anthracnose (1,3) showed that the isolated fungi belong to the C. spaethianum clade. Sequences of the isolates obtained in this study were deposited in GenBank (ACT Accession Nos. KC598114 and KC598115; CHS-1 Accession Nos. KC598116 and KC598117; GPDH Accession Nos. KC598118 and KC598119; ITS Accession Nos. KC598120 and KC598121). Cultures are deposited in the Culture Collection of Phytopathogenic Fungi of the Universidade Federal Rural de Pernambuco, Recife, Brazil (CMM1224 and CMM1225). Pathogenicity tests were conducted with the two C. spaethianum strains on daylily leaves. Mycelial plugs taken from the margin of actively growing colonies (PDA) of each isolate were applied in shallow wounds near the tip leaves. Four detached leaves were inoculated for each isolate, and PDA discs without fungal growth were used as controls. The leaves were maintained in humid chamber for 2 days at 25°C under a 12-h photoperiod. Anthracnose symptoms that closely resembled those observed in the affected nurseries were developed up to 5 days after inoculation. No symptoms developed on the control plants. C. spaethianum was successfully re-isolated from symptomatic plants to fulfill Koch's postulates. C. spaethianum was described from H. fulva and H. citrina in China, Hosta sielbodiana in Germany, and Lilium sp. in South Korea (3), and from Peucedanum praeruptorum in China (2). To our knowledge, this is the first report of C. spaethianum in Brazil and the first report on H. flava. References: (1) U. Damm et al. Fungal Divers. 39:45, 2009. (2) M. Guo et al. Plant Dis. 97:1380, 2013. (3) Y. Yang et al. Trop. Plant Pathol. 37:165, 2012.

Serological and molecular survey of Leishmania infection in dogs from Luanda, Angola

Background

Canine leishmaniosis (CanL) due to Leishmania infantum is a global zoonosis endemic in more than 70 countries in Europe, North Africa, Asia and America; however, data on this infection is scarce from southern Africa. The aim of this study was to survey dogs in Luanda, Angola, for Leishmania infection.

Findings

One hundred-and-three dogs presented to a veterinary medical centre in Luanda were serologically and molecularly assessed for Leishmania with the direct agglutination test (DAT) and polymerase chain reaction (PCR). Two dogs were seropositive, with DAT titres of 800 and ≥6400; the latter was also found to be PCR-positive and confirmed to be infected with L. infantum by DNA sequence analysis. No other dog was found to be PCR-positive. The first dog had been imported from Portugal, but the latter had never left Angola (neither had its parents), strongly suggesting an autochthonous infection.

Conclusions

Although other cases of CanL have previously been described in the country, this is the first reported study of canine Leishmania infection at the population level, as well as the first report on the molecular characterization of L. infantum in dogs from Angola.

New concepts in white adipose tissue physiology

Numerous studies address the physiology of adipose tissue (AT). The interest surrounding the physiology of AT is primarily the result of the epidemic outburst of obesity in various contemporary societies. Briefly, the two primary metabolic activities of white AT include lipogenesis and lipolysis. Throughout the last two decades, a new model of AT physiology has emerged. Although AT was considered to be primarily an abundant energy source, it is currently considered to be a prolific producer of biologically active substances, and, consequently, is now recognized as an endocrine organ. In addition to leptin, other biologically active substances secreted by AT, generally classified as cytokines, include adiponectin, interleukin-6, tumor necrosis factor-alpha, resistin, vaspin, visfatin, and many others now collectively referred to as adipokines. The secretion of such biologically active substances by AT indicates its importance as a metabolic regulator. Cell turnover of AT has also recently been investigated in terms of its biological role in adipogenesis. Consequently, the objective of this review is to provide a comprehensive critical review of the current literature concerning the metabolic (lipolysis, lipogenesis) and endocrine actions of AT.

Predisposing Factors for Traumatic Dental Injury in Primary Teeth and Seeking of Post-trauma Care

The aim of the present study was to investigate predisposing factors for traumatic dental injury (TDI) in the primary dentition and seeking of dental care after the occurrence of TDI. A randomized population-based cross-sectional study was carried out with 814 children aged 3 to 5 years enrolled at public and private preschools in the city of Campina Grande, PB, Brazil. Parents were asked to fill out a questionnaire on demographic data and the child's history of TDI. TDI was evaluated by clinical examinations performed by three previously calibrated dentists (Kappa: 0.85 to 0.90). Bivariate and multivariate Poisson regression models were constructed for TDI and the parent-reported search for dental care (α=0.05). The prevalence of TDI was 34.6%. The most common type of TDI was enamel fracture (55.0%). The central incisors were the most frequently affected teeth (87.5%). Predictors for TDI in the primary dentition were household income >U$312.50 (PR: 1.355; 95% CI: 1.050-1.724) and overjet >2 mm (PR: 1.539; 95% CI: 1.219-1.942). The predictor for seeking dental care following TDI was parent's age >30 years (PR: 1.753; 95% CI: 1.039-2.960). Household income and overjet were associated with TDI. Among children having suffered TDI, parent's age is a crucial determinant for seeking dental care.

Fatores individuais e contextuais associados à má oclusão em crianças brasileiras

OBJETIVO: Avaliar a associação entre a prevalência de má oclusão em crianças aos 12 anos de idade com variáveis individuais e contextuais. MÉTODOS: Foi realizado um estudo transversal analítico com dados da Pesquisa Nacional de Saúde Bucal – SBBrasil 2010. O desfecho estudado foi a má oclusão, categorizada em ausente, definida, severa e muito severa. As variáveis independentes foram classificadas em individuais e contextuais. Os dados foram analisados por meio de modelo multinível, considerando nível de 5% de significância. RESULTADOS: A prevalência de má oclusão severa e muito severa nas crianças com 12 anos de idade não diferiu entre as regiões brasileiras, mas sim entre as cidades (p < 0,001). Crianças do sexo masculino (p = 0,033), de menor renda (p = 0,051), que consultaram o dentista (p = 0,009), com menor satisfação com a boca e os dentes (p < 0,001) e com vergonha de sorrir (p < 0,001) apresentaram má oclusão de maior gravidade. As características das cidades também afetaram a gravidade da má oclusão; cidades com mais famílias com benefício social por 1.000 habitantes, com menores notas do índice de desempenho do sistema de saúde e menor renda per capita foram estatisticamente associadas com a má oclusão. CONCLUSÕES: Associações significativas entre a presença e gravidade da má oclusão foram observadas em nível individual e contextual.

A biorefinery from Nannochloropsis sp. microalga--extraction of oils and pigments. Production of biohydrogen from the leftover biomass

The microalga Nannochloropsis sp. was used in this study, in a biorefinery context, as biomass feedstock for the production of fatty acids for biodiesel, biohydrogen and high added-value compounds. The microalgal biomass, which has a high lipid and pigment content (mainly carotenoids), was submitted to supercritical CO2 extraction. The temperature, pressure and solvent flow-rate were evaluated to check their effect on the extraction yield. The best operational conditions to extract 33 g lipids/100 g dry biomass were found to be at 40 °C, 300 bar and a CO2 flow-rate of 0.62 g/min. The effect of adding a co-solvent (ethanol) was also studied. When supercritical CO2 doped with 20% (w/w) ethanol was used, it was possible to extract 45 g lipids/100 g dry biomass of lipids and recover 70% of the pigments. Furthermore, the remaining biomass after extraction was effectively used as feedstock to produce biohydrogen through dark fermentation by Enterobacter aerogenes resulting in a hydrogen production yield of 60.6 mL/g dry biomass.

Sociodemographic, biological and behavioural risk factors associated with incidence of dental caries in schoolchildren's first permanent molars: a 3-year follow-up study

AIM

This was to investigate the incidence of dental caries on the occlusal surface of the first permanent molars of schoolchildren, and also the associated sociodemographic, behavioural and biological risk factors.

MATERIALS AND METHODS

A three-year longitudinal study on dental caries of the occlusal surface of the first permanent molars was carried out in 224 children between 9 and 11 years of age, from two public schools in Brazil. Sociodemographic, behavioural and biological risk factors were correlated with the dental caries incidence. Data collection involved dental examination and a structured questionnaire. The dependent variable was the occurrence of carious lesion. Independent variables were (baseline): age, sex, previous dental treatment, tooth brushing frequency, fluoride history of use, monthly family income, mother's education level, caries experience, visible dental plaque, and the eruption stage of the teeth in question.

RESULTS

Statistics revealed a 25.4% occurrence of dental caries on the occlusal surface of the first permanent molars. The presence of visible dental plaque and history of caries (baseline) were considered risk factors for the presence of carious lesions in the examined teeth (p<0.05).

CONCLUSION

Dental caries on the occlusal surface of first permanent molars was associated with a history of dental caries and presence of dental plaque on the teeth in question in the first phase of the study.

Cross-cultural adaptation and validation of a Brazilian version of an instrument to assess impairments related to oral functioning of people with Down syndrome

Background

An instrument was developed in Canada to assess impairments related to oral functioning of individuals with four years of age or older with Down syndrome (DS). The present study attempted to carry out the cross-cultural adaptation and validation of the instrument for the Brazilian Portuguese language and to test its reliability and validity.

Findings

After translation and cross-cultural adaptation, the instrument was tested on caregivers of people with DS. Clinical examination for malocclusion was carried out in people with DS by two calibrated examiners. Inter and Intra examiner agreement was assessed by Intraclass Correlation Coefficient (ICC) and ranged from 0.92 to 0.97 respectively. Total of 157 people with DS and their caregivers were able to compose the sample. They were selected from eight institutions for people with DS in five cities of southeastern Brazil. The mean age of people with DS was 20.7 [±13.1] and for caregivers was 53.1 [±13.7]. The mean instrument score was 18.6 [±9.0]. Internal reliability ranged from 0.49 to 0.80 and external reliability ranged from 0.78 to 0.88. Construct validity was verified by significant correlations identified between malocclusion and the total instrument; and caregivers’ educational level and the instrument (p<0.05). Discriminant validity was proved as the instrument presented different mean comparing people with DS and non-DS (p<0.05).

Conclusions

Initial validity tests indicated that the instrument related to the oral health for people with DS may be a valid instrument to this segment of the population in Brazil.