Protease inhibitors extracted from caesalpinia echinata lam. Affect kinin release during lung inflammation

Inflammation is an essential process in many pulmonary diseases in which kinins are generated by protease action on kininogen, a phenomenon that is blocked by protease inhibitors. We evaluated kinin release in an in vivo lung inflammation model in rats, in the presence or absence of CeKI (C. echinata kallikrein inhibitor), a plasma kallikrein, cathepsin G, and proteinase-3 inhibitor, and rCeEI (recombinant C. echinata elastase inhibitor), which inhibits these proteases and also neutrophil elastase. Wistar rats were intravenously treated with buffer (negative control) or inhibitors and, subsequently, lipopolysaccharide was injected into their lungs. Blood, bronchoalveolar lavage fluid (BALF), and lung tissue were collected. In plasma, kinin release was higher in the LPS-treated animals in comparison to CeKI or rCeEI groups. rCeEI-treated animals presented less kinin than CeKI-treated group. Our data suggest that kinins play a pivotal role in lung inflammation and may be generated by different enzymeshowever, neutrophil elastase seems to be the most important in the lung tissue context. These results open perspectives for a better understanding of biological process where neutrophil enzymes participate and indicate these plant inhibitors and their recombinant correlates for therapeutic trials involving pulmonary diseases.Fundacao de Amparo a Pesquisa do Estado de Sao Paulo [04/11015-0, 07/55496-0, 01/02457-0]Conselho Nacional de Desenvolvimento Cientifico e Tecnologico [304923/2006-0, 304719/2009-9]Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior/Ministerio da Educacao Superior de Cuba (CAPES/MES), Brazil [011/06, 077/09]Department of Biochemistry, Universidade Federal de S˜ao Paulo, Rua Trˆes de Maio, No. 100, 04044-020 S˜ao Paulo, SP, BrazilSchool of Arts, Sciences and Humanities, Universidade de São Paulo, Avenida Arlindo Bettio, No. 1000, 03828-000 São Paulo, SP, BrazilDepartment of Marine Sciences, Universidade Federal de São Paulo, Rua Doutor Carvalho de Mendonça, No. 144, 11070-100 Santos, SP, BrazilJapan Health Care College, Sinei 434-1, Kiyota-ku, Sapporo, JapanDepartment of Marine Sciences, Universidade Federal de São Paulo, Rua Doutor Carvalho de Mendonça, No. 144, 11070-100 Santos, SP, BrazilFAPESP: 04/11015-0FAPESP: 07/55496-0FAPESP: 01/02457-0CNPq: 304923/2006-0CNPq: 304719/2009-9CAPES/MES: 011/06 and 077/09Web of Scienc

Prevalence and factors associated to dysphonia and laryngeal lesions: a study among teachers in a region of the Brazilian Legal Amazon

Objective: to investigate the prevalence and factors associated with dysphonia and laryngeal lesions in teachers of basic education in a region of the Amazonian region. Methods: cross-sectional study with collection of sociodemographic variables, occupational, environmental and clinics. Laryngeal lesions were evaluated by laryngoscopy. Was used a logistic regression to determine factors associated. Results: the prevalence of dysphonia and laryngeal lesions was 68.9% and 53.3%, respectively. There was association between self-reported dysphonia and respiratory problems (OR=3.00; CI95%=1.25-7.22), use of drugs (OR= 2.31, CI95%= 1.19-4.49) and noise in the internal environment (OR= 2.43; CI95%=1.24-4.73). Easy access to water was a protection factor against self-reported dysphonia (OR=0.09; CI95%: 0.01-0.79).  We found a significant association between dysphonia diagnosed and digestive problems (OR= 6.09; CI95%=2.79-13.30), external noise (OR=5.20, CI95%=1.99-13.57) and inadequate ventilation (OR=3.24; CI95%=1.36-7.74). The variables associated with higher chance of laryngeal lesions in dysphonic teachers were lighting (OR=3.74; CI95%=1.15-12.14%), acoustics (OR= 4.14; CI95%=1.32-12.95) and inadequate room size (OR= 3.76; CI95%=1.29-10.91). The use of drugs (OR=0.34; CI95%=0.12-0.92), respiratory problems (OR=0.21; CI95%=0.06-0.76) and easy access to water (OR= 0.12; CI95%=0.04-0.38) were protection factors for laryngeal lesions. Conclusion: occupational environmental factors aggravated the vocal health of this professional category. Access to water in the work impacted positively

Biochemical Aspects of a Serine Protease from Caesalpinia echinata Lam. (Brazilwood) Seeds: A Potential Tool to Access the Mobilization of Seed Storage Proteins

Several proteins have been isolated from seeds of leguminous, but this is the first report that a protease was obtained from seeds of Caesalpinia echinata Lam., a tree belonging to the Fabaceae family. This enzyme was purified to homogeneity by hydrophobic interaction and anion exchange chromatographies and gel filtration. This 61-kDa serine protease (CeSP) hydrolyses H-D-prolyl-L-phenylalanyl-L-arginine-p-nitroanilide (Km 55.7 μM) in an optimum pH of 7.1, and this activity is effectively retained until 50°C. CeSP remained stable in the presence of kosmotropic anions (PO4 3−, SO4 2−, and CH3COO−) or chaotropic cations (K+ and Na+). It is strongly inhibited by TLCK, a serine protease inhibitor, but not by E-64, EDTA or pepstatin A. The characteristics of the purified enzyme allowed us to classify it as a serine protease. The role of CeSP in the seeds cannot be assigned yet but is possible to infer that it is involved in the mobilization of seed storage proteins

PERCEPCIÓN DE LA FIGURA PATERNA DELANTE DEL AMAMANTAMIENTO MATERNO

Considering the importance of breastfeeding, the necessity arose of investigating the fathers’ participation in, and perception of, breastfeeding. This exploratory-descriptive research with a qualitative approach was carried out in the Frei Damião Maternity Hospital in the county of João Pessoa-PB with ten fathers in April 2011. It was observed that the majority of the fathers were quite interested in and committed to carrying out this new task of helping their wives, as they knew the advantages of breastfeeding. Some of them however did not have this knowledge and equally did not include themselves in breastfeeding, saying it was a moment for the mother and baby alone. There is a necessity for fathers to be included in health education activities taking place in the pre- and post-birth periods and those which follow in child-rearing, as caring for a baby is the responsibility of the couple.Considerando la importancia del amamantamiento materno surgió la necesidad de investigar la participación y la percepción de los padres delante de la práctica del amamantamiento materno. Investigación del tipo exploratorio-descriptiva con abordaje cualitativa, realizada en la Maternidad Frei Damião, en municipio de João Pessoa,PB, con 10 padres en abril de 2011. Se ha observado que la mayoría de los padres se mostraron muy interesados y empeñados en efectuar esa nueva tarea de auxiliar las esposas, pues conocían las ventajas del amamantamiento materno. Sin embargo algunos de ellos no tenían ese conocimiento y tampoco se incluían en esta práctica, afirmando ser un momento sólo de la madre y del bebé. Existe la necesidad de inserir la figura paterna en las actividades de educación en salud desarrolladas durante el prenatal y el puerperio, y las que se siguen en la puericultura, una vez que los cuidados con el bebé son de responsabilidad de la pareja.Considerando a importância do Aleitamento Materno surgiu a necessidade de investigar a participação e a percepção dos pais diante da prática do Aleitamento Materno. Pesquisa do tipo exploratório- descritiva com abordagem qualitativa, realizada na Maternidade Frei Damião, no município de João Pessoa-PB com 10 pais em abril de 2011. Observou-se que a maioria dos pais se mostraram bastante interessados e empenhados em efetuar essa nova tarefa de auxiliar as esposas, pois conheciam as vantagens do aleitamento materno, porém, alguns deles não tinham tal conhecimento, e também não se incluíam nesta prática, referindo ser um momento apenas da mãe e do bebê. Existe a necessidade de inserir a figura paterna nas atividades de educação em saúde desenvolvidas durante o pré-natal e o puerpério, e as que se seguem na puericultura, uma vez que os cuidados com o bebê são de responsabilidade do casal

O mito da democracia racial no contexto do sistema de cotas para estudantes negros: tudo continua como dantes no quartel de abrantes / The myth of racial democracy in the context of the cotests system for black students: everything goes on as before

A presente pesquisa aborda sobre o mito da democracia racial brasileira no contexto pós-aprovação da Lei 12.711/12, a qual institui as cotas étnicas e raciais nas universidades federais e institutos federais de ensino superior. O estudo é derivado de várias pesquisas sobre o sistema de cotas para negros na Universidade Federal do Maranhão. É um artigo que reflete acerca das consequências da não exigência da comprovação dos candidatos nos vestibulares se autodeclararem negros. Esse fato, o estudo conclui que o mito da democracia racial se revitaliza. A pesquisa está materializada em duas partes: na primeira parte e feita uma retrospectiva histórica do mito da democracia racial brasileira e na segunda parte é feita uma discussão sobre o mito da democracia racial no contexto do sistema de cotas para negros, especificamente a Lei 12.711/12. A pesquisa conclui afirmando que da forma como está funcionando o sistema de cotas para negros à luz da referida Lei vai permitir veladamente o retorno do mito da democracia racial brasileira

Global, regional, and national burden of osteoarthritis, 1990–2020 and projections to 2050: a systematic analysis for the Global Burden of Disease Study 2021

Background Osteoarthritis is the most common form of arthritis in adults, characterised by chronic pain and loss of mobility. Osteoarthritis most frequently occurs after age 40 years and prevalence increases steeply with age. WHO has designated 2021–30 the decade of healthy ageing, which highlights the need to address diseases such as osteoarthritis, which strongly affect functional ability and quality of life. Osteoarthritis can coexist with, and negatively effect, other chronic conditions. Here we estimate the burden of hand, hip, knee, and other sites of osteoarthritis across geographies, age, sex, and time, with forecasts of prevalence to 2050. Methods In this systematic analysis for the Global Burden of Disease Study, osteoarthritis prevalence in 204 countries and territories from 1990 to 2020 was estimated using data from population-based surveys from 26 countries for knee osteoarthritis, 23 countries for hip osteoarthritis, 42 countries for hand osteoarthritis, and US insurance claims for all of the osteoarthritis sites, including the other types of osteoarthritis category. The reference case definition was symptomatic, radiographically confirmed osteoarthritis. Studies using alternative definitions from the reference case definition (for example self-reported osteoarthritis) were adjusted to reference using regression models. Osteoarthritis severity distribution was obtained from a pooled meta-analysis of sources using the Western Ontario and McMaster Universities Arthritis Index. Final prevalence estimates were multiplied by disability weights to calculate years lived with disability (YLDs). Prevalence was forecast to 2050 using a mixed-effects model. Findings Globally, 595 million (95% uncertainty interval 535–656) people had osteoarthritis in 2020, equal to 7·6% (95% UI 6·8–8·4) of the global population, and an increase of 132·2% (130·3–134·1) in total cases since 1990. Compared with 2020, cases of osteoarthritis are projected to increase 74·9% (59·4–89·9) for knee, 48·6% (35·9–67·1) for hand, 78·6% (57·7–105·3) for hip, and 95·1% (68·1–135·0) for other types of osteoarthritis by 2050. The global age-standardised rate of YLDs for total osteoarthritis was 255·0 YLDs (119·7–557·2) per 100 000 in 2020, a 9·5% (8·6–10·1) increase from 1990 (233·0 YLDs per 100 000, 109·3–510·8). For adults aged 70 years and older, osteoarthritis was the seventh ranked cause of YLDs. Age-standardised prevalence in 2020 was more than 5·5% in all world regions, ranging from 5677·4 (5029·8–6318·1) per 100 000 in southeast Asia to 8632·7 (7852·0–9469·1) per 100 000 in high-income Asia Pacific. Knee was the most common site for osteoarthritis. High BMI contributed to 20·4% (95% UI –1·7 to 36·6) of osteoarthritis. Potentially modifiable risk factors for osteoarthritis such as recreational injury prevention and occupational hazards have not yet been explored in GBD modelling. Interpretation Age-standardised YLDs attributable to osteoarthritis are continuing to rise and will lead to substantial increases in case numbers because of population growth and ageing, and because there is no effective cure for osteoarthritis. The demand on health systems for care of patients with osteoarthritis, including joint replacements, which are highly effective for late stage osteoarthritis in hips and knees, will rise in all regions, but might be out of reach and lead to further health inequity for individuals and countries unable to afford them. Much more can and should be done to prevent people getting to that late stage

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019 : a comprehensive demographic analysis for the Global Burden of Disease Study 2019

Background: Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. Methods: 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10–14 and 50–54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. Findings: The global TFR decreased from 2·72 (95% uncertainty interval [UI] 2·66–2·79) in 2000 to 2·31 (2·17–2·46) in 2019. Global annual livebirths increased from 134·5 million (131·5–137·8) in 2000 to a peak of 139·6 million (133·0–146·9) in 2016. Global livebirths then declined to 135·3 million (127·2–144·1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2·1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27·1% (95% UI 26·4–27·8) of global livebirths. Global life expectancy at birth increased from 67·2 years (95% UI 66·8–67·6) in 2000 to 73·5 years (72·8–74·3) in 2019. The total number of deaths increased from 50·7 million (49·5–51·9) in 2000 to 56·5 million (53·7–59·2) in 2019. Under-5 deaths declined from 9·6 million (9·1–10·3) in 2000 to 5·0 million (4·3–6·0) in 2019. Global population increased by 25·7%, from 6·2 billion (6·0–6·3) in 2000 to 7·7 billion (7·5–8·0) in 2019. In 2019, 34 countries had negative natural rates of increase; in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58·6 years (56·1–60·8) in 2000 to 63·5 years (60·8–66·1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019