Oral N-acetylcysteine in the treatment of Raynaud's phenomenon secondary to systemic sclerosis: A randomized, double-blind, placebo-controlled clinical trial

Objective To evaluate the safety and efficacy of oral N-acetylcysteine (NAC) on digital microcirculation blood flow in patients with Raynaud's phenomenon (RP) secondary to systemic sclerosis (SSc). Methods This was a randomized, double-blind, placebo-controlled trial in which 42 patients with SSc received oral NAC at a dose of 600mg tid (21 patients, mean age 45.6±9.5 years) or placebo (21 patients, mean age 45.0±12.7 years) for four weeks. The primary endpoint was the change in cutaneous microcirculation blood flow before and after cold stimulation measured by laser Doppler imaging (LDI) at weeks 0 and 4. The frequency and severity of RP and the number of digital ulcers were also measured at weeks 0 and 4. The adverse events were recorded in the fourth week. Results There was no significant change in digital blood flow assessed by LDI before or after cold stimulus after four weeks of NAC or placebo. Both groups showed significant improvement in the frequency and severity of RP attacks, with no difference between the two groups. At the end of the study, the placebo group had three digital ulcers, while the NAC group showed no ulcers. NAC was well tolerated and no patient discontinued the treatment. Conclusions NAC orally at a dose of 1800mg/day showed no vasodilator effect on hands’ microcirculation after four weeks of treatment in patients with RP secondary to SSc.Objetivo Avaliar a segurança e a eficácia da N-acetilcisteína (NAC) por via oral sobre o fluxo sanguíneo da microcirculação digital em pacientes com fenômeno de Raynaud (FRy) secundário à esclerose sistêmica (ES). Métodos Este foi um estudo randomizado, duplo-cego e placebo-controlado, no qual 42 pacientes com ES receberam NAC oral na dose de 600 mg, três vezes ao dia (21 pacientes, idade média 45,6±9,5 anos) ou placebo (21 pacientes, idade média 45,0±12,7 anos) durante quatro semanas. O desfecho primário do estudo foi: melhora no fluxo sanguíneo da microcirculação cutânea antes e após estímulo frio avaliado pelo laser Doppler imaging (LDI) nas semanas 0 e 4. A frequência e a gravidade do FRy e o número de úlceras digitais também foram avaliados nas semanas 0 e 4. Os efeitos adversos foram registrados na quarta semana. Resultados Não houve mudança significativa no fluxo sanguíneo digital avaliado pelo LDI antes ou depois do estímulo frio após quatro semanas de NAC ou placebo. Ambos os grupos apresentaram melhora significativa na frequência e gravidade dos ataques de FRy, sem diferença entre os dois. O grupo placebo apresentou três úlceras digitais enquanto o grupo NAC não apresentou úlceras ao final do estudo. NAC foi bem tolerada e nenhum paciente descontinuou o tratamento. Conclusões NAC por via oral na dose de 1.800mg/dia não demonstrou efeito vasodilatador sobre a microcirculação das mãos após quatro semanas de tratamento em pacientes com FRy secundário à ES.Universidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Production batch sizing and inventory level control using simulation software

Computer simulation has great application potential in the area of Production Engineering as a tool to support decision making as it allows to simulate the functioning of a real system through logical relationships, in order to observe its behavior under different scenarios. Which could not be practiced in the real system. In line with this aspect, the present work aims to present a report on the application of simulation for the design of production batches and inventory control, highlighting the process necessary for the construction of the generated simulation model, as well as the challenges and opportunities observed. In order to achieve the proposed objective, a literature review was carried out on the topics of interest; the choice and understanding of simulation software and; the survey of data from a large auto parts manufacturer located in the interior of the state of São Paulo. The main results were an increase in production volume from the inclusion and dimensioning of a buffer after the assembly process and a balance between the number of items of each component of the product structure in the supply with the real capacity of manufacturing cell processing. Cabe ressaltar que o modelo de simulação produto da pesquisa deste artigo pode ser aplicado como um sistema de apoio à decisão do gestor para a elaboração do planejamento estratégico e do planejamento operacional com o propósito de melhorar a capacidade de análise e decisão. It is important mentioning that the simulation model in this article can be applied as a support system decision for the preparation of strategic planning and operational planning, with the purpose of improving the analysis capacity for decision-making

Is the algorithm used to process heart rate variability data clinically relevant? Analysis in male adolescents

OBJECTIVE: To analyze whether the algorithm used for the heart rate variability assessment (fast Fourier transform versus autoregressive methods) influenced its association with cardiovascular risk factors in male adolescents. METHODS: This cross-sectional study included 1,152 male adolescents (aged 14 to 19 years). The low frequency, high frequency components (absolute numbers and normalized units), low frequency/high frequency ratio, and total power of heart rate variability parameters were obtained using the fast Fourier transform and autoregressive methods, while the adolescents were resting in a supine position. RESULTS: All heart rate variability parameters calculated from both methods were different (p<0.05). However, a low effect size (<0.1) was found for all parameters. The intra-class correlation between methods ranged from 0.96 to 0.99, whereas the variation coefficient ranged from 7.4 to 14.8%. Furthermore, waist circumference was negatively associated with high frequency, and positively associated with low frequency and sympatovagal balance (p<0.001 for both fast Fourier transform and autoregressive methods in all associations). Systolic blood pressure was negatively associated with total power and high frequency, whereas it was positively associated with low frequency and sympatovagal balance (p<0.001 for both fast Fourier transform and autoregressive methods in all associations). Body mass index was negatively associated with high frequency, while it was positively associated with low frequency and sympatovagal balance (p values ranged from <0.001 to 0.007). CONCLUSION: There are significant differences in heart rate variability parameters obtained with the fast Fourier transform and autoregressive methods in male adolescent; however, these differences are not clinically significant. OBJETIVO: Analisar se o algoritmo usado para avaliação da variabilidade da frequência cardíaca (transformada rápida de Fourier versus autoregressivo) influencia em sua associação com fatores de risco cardiovascular adolescentes do gênero masculino. MÉTODOS: Estudo transversal, que incluiu 1.152 adolescentes do gênero masculino (14 a 19 anos). Componentes de baixa e alta frequência (absolutos e unidades normalizadas), razão componente de baixa frequência/componente de alta frequência e poder total da variabilidade da frequência cardíaca foram obtidos em repouso, na posição supina, usando os métodos transformada rápida de Fourier e autorregressivo. RESULTADOS: Todos os parâmetros da variabilidade da frequência cardíaca para ambos os métodos foram diferentes (p<0,05). Entretanto, um pequeno tamanho do efeito (<0,1) foi observado para todos os parâmetros. Os coeficientes de correlação intraclasse entre os métodos variaram de 0,96 a 0,99, enquanto os coeficientes de variação foram de 7,4 a 14,8%. A circunferência abdominal foi negativamente associada com o componente de alta frequência, e positivamente associada com o componente de baixa frequência e o balanço simpatovagal (p<0,001 para a transformada rápida de Fourier e o autorregressivo em todas as associações). A pressão arterial sistólica foi negativamente associada com o poder total e o componente de alta frequência, enquanto foi positivamente associada com o componente de baixa frequência e o balanço simpatovagal (p<0,001 para a transformada rápida de Fourier e o autorregressivo em todas as associações). O índice de massa corporal foi negativamente associado com o componente de alta frequência, enquanto foi positivamente associado com o componente de baixa frequência e o balanço simpatovagal (valores de p variando de <0,001 a 0,007). CONCLUSÃO: Houve diferenças significantes nos parâmetros da variabilidade da frequência cardíaca obtidos com os métodos transformada rápida de Fourier e autorregressivo em adolescentes masculinos, mas essas diferenças não foram clinicamente significativas

Simultaneous thrombosis in two epicardial coronary arteries during acute myocardial infarction

Young patient with a history of smoking, hypertension and use of illicit drugs (cannabis, cocaine and crack) was admitted with precordial pain after physical exercise within the previous two hours. Electrocardiogram demonstrated ST segment elevation in leads V1 to V4 and the patient was referred to cardiac catheterization, which showed total occlusion of the left anterior descending artery and a large amount of thrombi in the right coronary artery. The patient was treated with direct stenting in the left anterior descending artery and triple antiplatelet therapy with aspirin, clopidogrel and abciximab in combination with non-fractioned heparin for 24 hours. Angiography and intravascular ultrasound assessment after 48 hours demonstrated a complete resolution of thrombi in both coronary arteries.Paciente jovem, com histórico de tabagismo, hipertensão arterial e uso de drogas ilícitas (cannabis, cocaína e crack), foi admitido com dor precordial após atividade física, com cerca de duas horas de evolução. O eletrocardiograma demonstrou supradesnivelamento do segmento ST de V1 a V4, e o paciente foi encaminhado para cateterismo cardíaco, que evidenciou oclusão total da artéria descendente anterior e grande quantidade de trombos na coronária direita. Foi tratado com implante direto de stents na artéria descendente anterior e terapia antiplaquetária tripla com aspirina, clopidogrel e abciximab associada a heparina não-fracionada, mantidas por 24 horas. Reavaliações angiográfica e ultrassonográfica após 48 horas demonstraram resolução completa dos trombos em ambas as coronárias.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Setor de Hemodinâmica e Cardiologia IntervencionistaUNIFESP, EPM, Setor de Hemodinâmica e Cardiologia IntervencionistaSciEL

Conocimientos riberos que proviene del igapó: Plantas consumidas por quelônios (Podocnemis spp.) em rio Andirá, Brasil

Alimentos vegetais podem representar mais de 90% da dieta das espécies de tartarugas aquáticas podocnemis. Grande parte desses alimentos vêm das florestas de várzea ou igapós, morada dos ribeirinhos que dominam o conhecimento das plantas, e também é habitat dos quelônios que as usam como alimento. Portanto, entrevistamos 39 ribeirinhos no período de 2019 a 2021, nas comunidades Granja e Piraí, Barreirinha, Amazonas. Com o objetivo de conhecer as plantas consumidas pelas tartarugas, através do saber tradicional dos ribeirinhos. Utilizando técnicas de pesquisa etnobiologica, usando métodos qualitativos e quantitativos de coleta dos dados: bola de neve, lista livre com análise do índice de Smith e rede social. Nas entrevistas foram indicadas 83 etnoespécies, catalogamos 59 espécies, distribuídas em 55 gêneros e 29 famílias botânicas. O capitarí (Handroanthus barbatus) apresentou maior índice de Smith, portanto foi a mais conhecida, seguido do tucuribá (Couepia paraensis), marajá (Bactris riparia), camu-camu (Myrciaria dubia) e o jauari (Astrocaryum jauari). Destacamos as famílias Fabaceae, Myrtaceae e Arecaceae por comtemplarem mais espécies indicadas. Dentre as plantas que catalogamos, as previamente descritas para as espécies de podocnemis na literatura pertenciam a 22 famílias (76%), 26 gêneros (47%) e 30 espécies (51%). Assim, 24% das espécies referem-se ao primeiro registro desses itens alimentares na dieta desses quelônios. Os conhecimentos tradicionais dos ribeirinhos devem ser considerados como informações prioritárias na formulação de estratégias de manutenção e restauração das florestas riparias, para conservação das populações de podocnemidídeos, orientando as legislações para que garantam a conservação dos sistemas sociobiodiversos considerando também o saber do caboclo ribeirinho.Edible plants can represent around 90% of the diet of some species of aquatic turtles of the genus podocnemis. These plants are found in floodplain forests and igapós, the riverside dwellers as well as turtles´ home. These dwellers dominate the common knowledge of those plants. Thus 39 dwellers were interviewed between 2019 and 2021, at Granja and Piraí communities, Barreirinha, Amazonas, Brazil. And, the plants that turtles feed on were identified by means of the traditional knowledge of these riverside dwellers. Ethnobiology techniques as, qualitative and quantitative methods of data collection, used were: snowball sampling, free list with Smith index analysis and social network. Among the 83 plant ethnospecies cited, we cataloged 59 species, distributed in 55 genera and 29 botanical families. Handroanthus barbatus had the highest Smith index, therefore it was the best known, followed by Couepia paraensis, Bactris riparia, Myrciaria dubia and Astrocaryum jauari. Fabaceae, Myrtaceae and Arecaceae families presented the greatest number of indicated species. Within the plants we cataloged, the previously described for podocnemis species in the literature belonged to 22 families (76%), 26 genera (47%) and 30 species (51%). So, 24% of species refer to the first record of these food items in podocnemidídeos diet. The riverside dwellers´traditional knowledge the must be considered as priority information in the maintanance and restoration of riparian forests, to chelonians populations conservation, and may even lead to the development of legislation and technical to garantee the socialbiodiverse systems conservation by means of the cultural knowledge of the riverside dwellers.Los alimentos vegetales pueden representar alrededor del 90% de la dieta da especies de tortugas acuáticas del género podocnemis. Estas plantas se encuentran en los bosques aluvial y los igapós, los habitantes de los ribereños y el casa de las tortugas. Estos habitantes dominan el conocimiento común de las plantas. Así fueron entrevistados 39 habitantes entre 2019 y 2021, en las comunidades Granja y Piraí, Barreirinha, Amazonas, Brasil. Y, las plantas de las que se alimentan las tortugas fueron identificadas mediante el conocimiento tradicional de estos ribereños. Las técnicas de etnobiología como métodos cualitativos y cuantitativos de recolección de datos utilizados fueron: muestreo de bola de nieve, análisis de lista libre con índice de Smith y redes sociales. Entre las 83 etnoespecies de plantas citadas, catalogamos 59 especies, distribuidas en 55 géneros y 29 familias botánicas. Las especies con mayor índice de Smith, por lo tanto las más conocidas, son: Handroanthus barbatus, Couepia paraensis, Bactris riparia, Myrciaria dubia e o Astrocaryum jauari. Las familias Fabaceae, Myrtaceae y Arecaceae presentaron el mayor número de especies indicadas. Dentro de las plantas catalogadas, las previamente descritas para las especies de podocnemis en la literatura pertenecieron a 22 familias (76%), 26 géneros (47%) y 30 especies (51%). Así, el 24% de las especies se refieren al primer registro de estos alimentos en la dieta de podocnemidídeos. Los conocimientos tradicionales de los ribereños deben ser considerados como información prioritaria en el mantenimiento y restauración de los bosques de riparians, para la conservación de las poblaciones de tortugas, e incluso pueden conducir al desarrollo de legislación que garanticen la conservación de los sistemas sociobiodiversos a través del conocimiento cultural

Synthesis, antileishmanial activity and QSAR studies of 2-chloro- N -arylacetamides

We describe herein the synthesis and evaluation of the antileishmanial activity against promastigote forms of Leishmania amazonensis and cytotoxicity to murine macrophages of a series of 2-chloro-N-arylacetamide derivatives. All compounds were active, except one (compound 3). Compound 5 presented the most promising results, showing good antileishmanial activity (CI50=5.39±0.67 µM) and moderate selectivity (SI=6.36), indicating that further development of this class is worthwhile. Preliminary QSAR studies, although not predictive, furnished some insights on the importance of electronic character of aryl substituent to biological activity, as well as an indirect influence of hydrophobicity on activity

Evaluation of the geotourism potential of the northern region of São Sebastião island (São Paulo, Brazil)

A motivação do presente estudo é o emprego da geoconservação no manejo de atrativos turísticos em unidades de conservação de proteção integral, com vistas ao geoturismo, tendo como área de estudo a região norte da Ilha de São Sebastião, no município de Ilhabela, SP. Foram inventariados 14 sítios de geodiversidade, e avaliados quantitativamente quanto aos potenciais usos turísticos convencional e de aventura, e valor científico. Para seleção dos sítios mais aptos ao geoturismo foram considerados aqueles que apresentaram simultaneamente alto potencial turístico, cuja relevância é condicionada por aspectos como logística, acessibilidade, apelo cênico e unicidade, e alto valor científico, cujas informa- ções constituem a matéria-prima das atividades interpretativas, adaptadas a uma linguagem acessível ao público leigo. Dentre os resultados obtidos, destacam-se os seguintes sítios de geodiversidade prioritários ao geoturismo: Sienitos da Praia da Garapocaia (SG9), Geodiversidade no Pico do Baepi (SG 6) e Caminhos geológicos das costas norte (SG11) e leste (SG 12).The present study aims to apply the geoconservation to tourist management in full-protection conservation units, focusing on geotourism. For this purposes, the study area is the northern region of São Sebastião Island, on the north coast of State of São Paulo, Brazil. Fourteen geodiversity sites were inventoried, which were quantitatively evaluated for the potential of conventional and adventure tourism and scientific value. The sites classified as most suitable for geotour ism projects are those that simultaneously presented high tourist potential, whose relevance is conditioned by aspects such as logistics, accessibility, scenic appeal and uniqueness, and scientific value, whose information constitutes the raw material of the interpretive activities, adapted to a language accessible to the lay public. Among the results obtained, the following geodiversity sites are highlighted as priority to geotourism: Syenites from Garapocaia Beach (SG9), Geodiversity in Baepi Peak (SG6) and North and East Coast Geological Paths (SG11 and SG12).CAPES -Coordenação de Aperfeiçoamento de Pessoal de Nível Superior(undefined

Production performance of Hylocereus polyrhizus based on cladode size and position

The analysis of productive architecture of plants involves macroscopic observation of spatial distributions of different vegetative and reproductive organs. However, few studies have evaluated these aspects in dragon fruit plants for production purposes. The objective of this study was to evaluate vegetative, reproductive, and quality parameters of dragon fruit plants (Hylocereus polyrhizus; variety Cebra) based on the position and size of cladodes, considering morphological, production, and quality characteristics of the fruits. The experiment was conducted from September 2016 to May 2018, using a completely randomized design in a 3×4 factorial arrangement, consisted of three positions of cladode insertion in the plant (primary, secondary, and tertiary) and four different cladode sizes (≤ 20 cm; 21-40 cm; 41-60 cm, and 61-80 cm), with five replications and six cladodes per plot, totaling 360 evaluated cladodes. According to the results, vegetative and reproductive characteristics of dragon fruit plants variety Cebra were affected by the cladode position and size. Fruits developed on primary cladodes with sizes of 21 to 40 cm presented, in general, better-quality characteristics. All evaluated physical and physicochemical characteristics were affected by the cladode position and size, except for titratable acidity and soluble solids to titratable acidity ratio. Fruits developed on cladodes smaller than 20 cm had lower quality. Therefore, maintaining and promoting the growth of primary cladodes with sizes of 21 to 40 cm and removing those smaller than 20 cm is recommended.The analysis of productive architecture of plants involves macroscopic observation of spatial distributions of different vegetative and reproductive organs. However, few studies have evaluated these aspects in dragon fruit plants for production purposes. The objective of this study was to evaluate vegetative, reproductive, and quality parameters of dragon fruit plants (Hylocereus polyrhizus; variety Cebra) based on the position and size of cladodes, considering morphological, production, and quality characteristics of the fruits. The experiment was conducted from September 2016 to May 2018, using a completely randomized design in a 3×4 factorial arrangement, consisted of three positions of cladode insertion in the plant (primary, secondary, and tertiary) and four different cladode sizes (≤ 20 cm; 21-40 cm; 41-60 cm, and 61-80 cm), with five replications and six cladodes per plot, totaling 360 evaluated cladodes. According to the results, vegetative and reproductive characteristics of dragon fruit plants variety Cebra were affected by the cladode position and size. Fruits developed on primary cladodes with sizes of 21 to 40 cm presented, in general, better-quality characteristics. All evaluated physical and physicochemical characteristics were affected by the cladode position and size, except for titratable acidity and soluble solids to titratable acidity ratio. Fruits developed on cladodes smaller than 20 cm had lower quality. Therefore, maintaining and promoting the growth of primary cladodes with sizes of 21 to 40 cm and removing those smaller than 20 cm is recommended