Cryptococcosis is an opportunistic systemic mycosis whose treatment is limited to three drugs. In this work, we evaluated the antifungal activity of a hexane extract (HE) from Spondias tuberosa leaves against Cryptococcus neoformans and Cryptococcus gattii. Minimal inhibitory concentrations (MIC) were determined, and putative mechanisms were evaluated by flow cytometry. In addition, an in vivo infection assay was performed using Tenebrio molitor larvae. Treatment with HE inhibited the growth of standard and clinical isolates of C. neoformans and C. gattii (MICs ranging from 0.78 to 3.12mg/mL), significantly (P<0.05) increased mitochondrial superoxide anion levels, and induced mitochondrial membrane depolarization, loss of lysosomal membrane integrity, and phosphatidylserine externalization. The mean survival time of C. gattii-infected T. molitor larvae significantly (P<0.05) increased from 1.225 days in control to 3.067 and 3.882 days in HE-treated groups (78 and 156mg/kg, respectively). In conclusion, HE showed anticryptococcal activity, induced mitochondrial and lysosomal damage in yeast cells, and exhibited anti-infective action against C. gattii in T. molitor larvae.

Jacaranda rugosa (Bignoniaceae) is an endemic tree in Brazil with a limited distribution restricted to Caatinga. This study aimed to evaluate ethanolic extracts of branches (BE) and leaves (LE) of J. rugosa to uncover the phytochemical profile using thin layer chromatography (TLC) and high performance liquid chromatography (HPLC). In addition, the extracts were evaluated for antibacterial activity using broth microdilution, antioxidant activity against free radicals DPPH and ABTS+, oral acute toxicity (2000 mg/kg) to mice, and in vivo antiinflammatory effects using a carrageenan-induced peritonitis model. The analysis by TLC identified the presence of flavonoids and steroids in both extracts. The HPLC profiles showed the presence of rutin in LE and rutin, quercetin, and hyperoside in BE, in addition to the phenylpropanoids that were detected in both extracts. LE showed bacteriostatic activity against Escherichia coli [minimal inhibitory concentration (MIC): 10 mg/mL)] and Streptococcus pyogenes (MIC: 20 mg/mL). The BE inhibited the growth of E. coli (MIC: 5 mg/ mL). The extracts were active against DPPH (IC50 of 17.04 and 9.37 mu g/mL for BE and LE, respectively) and ABTS+ (IC50 of 16.39 and 9.10 mu g/mL for BE and LE, respectively). In the acute toxicity test, no deaths or changes in physiological, biochemical, and hematological parameters were detected. In the peritonitis test, BE and LE significantly reduced the cell migration of leukocytes to the peritoneal exudate. The results highlight the species J. rugosa as a source of pharmacological resources. (c) 2020 SAAB. Published by Elsevier B.V. All rights reserved.

Poincianella (Caesalpinia) microphylla fractions were analyzed by LC-DAD-MS and by statistical tools to determine the possible bioactive compounds against T. vaginalis. Tannins enriched-fractions toxicity (M5 and M10) were analyzed in in vitro against human red cells and in in vivo model of Galleria mellonella. Twenty-six compounds were detected from the P. microphylla fractions. The main compounds identified were hydrolyzable tannins (gallotanins and ellagitannis), such as O-digalloyl hexoside, O-digalloyl HHDP -hexoside, tri-O-galloyl HHDP-hexoside, O-galloyl HHDP-DHHDP-hexoside and their isomers. In addition, procyanidin dimer, epicatechin, ellagic acid and O-(digalloyl) quinic acid were also identified. Based on univariate statistical analyses, stronger correlations with the anti-T. vaginalis properties were observed for the compounds 7 (O-galloyl HHDP-DHHDP-hexoside - Geraniin isomer), 3 (O-digalloyl HHDP -hexoside - mallotinic acid), 2 (O-digalloyl) quinic acid), 1 (O-digalloyl hexoside) and 9 (unknown). Tannins enriched-fractions (M5 and M10) presented anti-Trichomonas activity (IC50 70.41 µg/mL and 142.1 µg/mL, respectively) and no toxicity in the in vivo model of G. mellonella. This innovative approach allowed us to identify likely bioactive compounds in the extracts, although the mechanism(s) underlying anti-trichomonal activity encompass a complex trait.

Purpose: Environmental change impacts the transmission and spread of vector-borne diseases. Significant associations between climate factors and vector-borne diseases have enabled predictive models to be developed that can be used in early warning systems to forecast and anticipate disease epidemics. Malaria is one such vector-borne disease, with a global distribution and significant health burden that is highly sensitive to climatic factors. Additionally, malaria is experiencing a resurgence in transmission, threatening elimination efforts. Malaria is also sensitive to non-climatic factors, such as land-use change, political instability, insecticide resistance and the effectiveness of public health control interventions. A greater understanding of the relative role of climate and non-climate factors in driving malaria transmission is needed to develop predictive models, particularly under future global change scenarios. Methods & Materials: In this study, a 20-year dataset of monthly malaria cases was used to develop a spatiotemporal Bayesian modelling framework for evaluating the relative influences of climatic and non-climatic drivers of malaria incidence in El Oro province in southern Ecuador, an area historically endemic for Plasmodium vivax and P. falciparum. Between the 1980s and early 2000s, El Oro experienced a surge in malaria transmission and through an effective binational collaboration became effectively malaria free in 2011. However, there is still a high risk of re-emergence of malaria in the region. Results: The mixed model with the best fit included the climatic variables minimum temperature and precipitation. The addition of non-climate factors, including political instability and the addition of malaria intervention activities in El Oro were also included in this model. By interacting the climate covariates with malaria intervention periods, we found the association between climate and malaria risk changed significantly following the interventions. Conclusion: Distinct variation in spatially explicit random effects was found, which suggest that other environmental factors, such as land use change or area-specific intervention efforts should be explored to understand this variation. This study demonstrates that both environmental, socio-economic and political factors should be considered when developing predictive disease models, to understand the potential environmental suitability for re-emergence in the region, given a lapse in control efforts or periods of civil unrest.

and 31/11/2018, human beings, age group: 19+ years and any author who is a nurse. ResultsThe study selection process was developed according to the PRISMA 2009 Flow Diagram, assuring the methodological quality of it.Two studies were selected whose results are the necessity of using new and innovated strategies to support the caregivers, promoting their empowerment and enabling them for the care. ConclusionsThe obtained evidences indicate that the intervention of the nurse at home encourages the empowerment of the family caregiver, reducing the anxiety and stress, improving the general domains of physical and mental health, enabling them to care.

The objectives of this work were to produce nanoemulsions containing 1% (v/v) of Eugenia brejoensis Mazine essential oil (EO) at different rotation speeds (8000 and 12,000 rpm) and evaluate the antimicrobial effects of this EO against Pseudomonas fluorescens (ATCC 13525). Droplet average droplet size, size distribution, surface charge, and functional groups were taken into account. Droplet size was observed to decrease at higher rotation speeds (from 355.63 +/- 21.70 to 143.13 +/- 1.1 nm). Aggregation and sedimentation processes were prevented by a food-grade emulsifier, mainly in the system obtained at 8000 rpm. This stabilizing effect was confirmed by suitable zeta potential values (ca. - 30 mV). Both nanoemulsions presented in vitro inhibitory effect against P. fluorescens. Nonetheless, the nanoemulsion containing ca. 355-nm-dia droplets presented larger inhibition zones. Hence, this nanoemulsion was tested in sliced ham preservation, but decreased inhibitory effects compared to in vitro tests were observed because insufficient oil content was incorporated into the slices. Therefore, while these nanoemulsions presented in vitro antimicrobial effectiveness, their application in real food products may be feasible upon the optimization of their synthesis conditions.

AIM To evaluate the in vitro cytotoxicity and cytokine release of three fresh root canal sealers and to determine the type of cell death they induce. METHODOLOGY The sealers tested were Sealer 26 (S26), AH Plus (AHP), and Endosequence BC Sealer (END). Fresh sealers were cultivated in contact with monocytes and polymorphonuclears (PMNs) obtained from the peripheral blood of humans. Cell viability, apoptosis and necrosis were analysed at 4 h (PMNs) or 24 h (monocytes) using Annexin-V and propidium iodide in a cytometer. The supernatants were used to quantify Interleukin (IL)-4, IL-6, IL-10, IL-12 and tumour necrosis factor-α (TNF-α) in monocytes and IL-8 in PMNs by ELISA. One-way ANOVA and the Tukey post-test were used to compare data for cytotoxicity, and the multiple T-test was used to determine the differences between sealers in the release of cytokines that were statistically significant. RESULTS After 4 h of treatment, S26 was associated with greater cell viability than the other sealers (P < 0.05) in the PMN culture and had similar values of necrosis as END (P > 0.05). After 24 h of treatment, AHP and END had greater monocyte cell viability than S26 (P < 0.05), which had more necrosis (P < 0.05). END had the lowest levels of IL-12 compared to the other sealers (P < 0.05) and higher levels of IL-6 compared to S26 (P < 0.05). The tested sealers did not differ in the release of IL-8, IL-10, TNF-α and IL-4 (P > 0.05). CONCLUSIONS The effect of toxic agents released varied depending on the cell type studied. The composition of the sealers appeared to alter the form of self-regulation in the production of these cytokines by cells.

This article presents and performs a preliminary validation of a framework for supplier selection. It makes use of, in sequence, Kraljic's supplier relationship portfolio and the multi-criteria decision tool named the analytic hierarchy process (AHP). The proposal's main objective is to provide companies with a practical and easy-to-use tool for classifying the importance and criticality of raw materials and for selecting suppliers based on a hierarchy. One result of this action-based study is the preliminary validation of the proposed model through its application in an electronics company. The application of the method suggests an improvement in the company's supplier selection practices related to one key item of one of its products.

BACKGROUND: Heart transplantation is the standard treatment for advanced heart failure. In Brazil, the second most common cause of heart failure is Chagas cardiomyopathy. About one million of brazilians are infected by the Trypanossoma cruzi. OBJECTIVE: To compare pre-transplant clinical features and post-transplant 12-months survival between chagasic and non chagasic patients.

Introduction: Although most cases of colon ischemia (CI) are mild and self-limiting, when severe it implies high mortality rates. We aimed to evaluate the risk predictive value of the classification proposed by American College of Gastroenterology (ACG) guidelines (2015), created to provide a management algorithm. Methods: A retrospective multicenter study was conducted on adult patients with definite CI (clinical, endoscopic, pathologic and culture criteria), between 2013 and 2016. Data was collected on clinical presentation, including comorbidities, organ failure, management and outcome. Cases were evaluated according to ACG risk factors (RF) (gender, systolic blood pressure, heart rate, abdominal pain without rectal bleeding, BUN, Hb, LDH, serum sodium, WBC). Cases were classified as mild (0 RF), moderate (1-3 RF) and severe (>3 RF or any of the following: peritoneal signs, pneumatosis or portal venous gas, gangrene, pan-colonic or isolated right-colon ischemia). Results: 349 cases with the clinical diagnosis of IC were analyzed. 193 met inclusion criteria of definitive diagnosis (63% females; mean age 72 years (±13). ACG classification of mild, moderate and severe disease was attributed respectively to 21% of patients (0 intra-hospital deaths), 45% (2 deaths) and 34% (12 deaths). The number of ACG RF was: 40% with 0 RF, 8% with 1, 9% with 2, 15% with 3, 16% with 4, 8% with 15%, 4% with 6 and 1% with 7. No patient with 0 or 1 RF died. Only 1 patient with 2 RF died. The remaining 13 deaths were verified with at least 3 RF. The univariate analysis revealed a statistical correlation between RF and intra-hospital or 30-day mortality as well as the need for surgery (P<0.001, P<0.001, and P=0.006, respectively). ACG classification presented high predictive accuracy for in-hospital and 1-month mortality with an AUROC of 0.78 and 0.79 (P<0.001), respectively. For a cutoff of 2 ACG RF, the sensibility (SE) for death was 100%, specificity (SP) was 52%, with a positive predictive value (PPV) of 14% and negative predictive value (NPV) of 100%. For 3 ACG RF the results were: SE 93%, SP 61%, PPV 16% and NPV 99%. Three or more RF had an OR of 20.2 (95%CI: 2.59-158) for intra-hospital and 18.4 (95% CI: 2.34-144) for 1-month mortality. Conclusion: No patient in this cohort with less than 2 ACG RF died, suggesting that mild disease of ACG classification may include 0 and 1 RF without changing prognosis. Short-term mortality risk increases significantly in patients with at least 3 ACG RF.Figure: ROC curve comparing the sensitivity of prediction of mortality at 1 month using the ACG classification, ACG classification adjusting mild disease until 1 RF and the number of ACG RF.

Background: Neuropsychological research in cardiovascular diseases has focused mainly in heart failure.The present systematic review aims to determine the incidence of neurocognitive dysfunction in acute coronary syndrome (ACS) and to define the neurocognitive functions most affected in ACS. Methods:The systematic review was performed in June 2016 on Pubmed.No restrictions were established regarding publication date, language, age of the participants in each study, nor type of study or experimental design.Results: Four studies were selected out of 74, once they address to at least one of the aims.The prevalence of neurocognitive dysfunction ranges between 10.51% and 66.8%.We could determinate the incidence rate in two studies, ranging from 0.0277 cases per year to 0.416 cases per month.Alterations in verbal memory, language and executive functioning were found. Conclusions:The variability of prevalence rates of neurocognitive dysfunction in ACS across studies may be due to the use of different neuropsychological instruments, different times of neuropsychological assessment and diverse demographical and clinical characteristics of the samples.In the future, further studies must clarify the neurocognitive tests that are more sensitive to ACS.The study of the interaction between risk factors, biomarkers, behavioral and environmental aspects as well as the clinical features of ACS and its treatment on brain and neurocognitive functioning, should also be clarified.