Cholinergic immunomodulation in inflammatory bowel diseases

Inflammatory bowel diseases (IBD) are chronic intestinal disorders characterized by dysregulated immune responses to resident microbiota in genetically susceptible hosts. The activation of the cholinergic system has been proposed for the treatment of IBD patients according to its potential anti-inflammatory effect in vivo. The α-7-nicotinic-acetylcholine receptor (α7nAChR) is involved in the inhibition of inflammatory processes, modulating the production of cytokines, suppressing dendritic cells and macrophage activity, leading to the suppression of T cells. In this review, we address the most recent studies and clinical trials concerning cholinergic signaling and its therapeutic potential for inflammatory bowel diseases

Temporal clinical, proteomic, histological and cellular immune responses of dextran sulfate sodium-induced acute colitis

AIM To investigate the temporal clinical, proteomic, histological and cellular immune profiles of dextran sulfate sodium (DSS)-induced acute colitis. METHODS Acute colitis was induced in C57BL/6 female mice by administration of 1%, 2% or 3% DSS in drinking water for 7 d. Animals were monitored daily for weight loss, stool consistency and blood in the stool, while spleens and colons were harvested on day 8. A time course analysis was performed in mice ingesting 3% DSS, which included colon proteomics through multiplex assay, colon histological scoring by a blinded investigator, and immune response through flow cytometry or immunohistochemistry of the spleen, mesenteric lymph node and colon. RESULTS Progressive worsening of clinical colitis was observed with increasing DSS from 1% to 3%. In mice ingesting 3% DSS, colon shortening and increase in proinflammatory factors starting at day 3 was observed, with increased spleen weights at day 6 and day 8. This coincided with cellular infiltration in the colon from day 2 to day 8, with progressive accumulation of macrophages F4/80+, T helper CD4+ (Th), T cytotoxic CD8+ (Tcyt) and T regulatory CD25+ (Treg) cells, and progressive changes in colonic pathology including destruction of crypts, loss of goblet cells and depletion of the epithelial barrier. Starting on day 4, mesenteric lymph node and/ or spleen presented with lower levels of Treg, Th and Tcyt cells, suggesting an immune cell tropism to the gut. These results demonstrate that the severity of experimental colitis is dependent on DSS concentration, correlated with clinical, proteomic, histological and cellular immune response on 3% DSS

Parental intervention improves motor development in infants at risk: case series

A intervenção precoce no desenvolvimento, por meio de atividades parentais, favorece ganhos cognitivos, físicos, sociais e emocionais da criança, que são determinantes da saúde infantil. Contudo, estudos com intervenção precoce com atividades parentais são escassos. Assim, o objetivo deste estudo foi analisar o efeito da intervenção parental precoce no desenvolvimento motor de lactentes em seguimento em ambulatório de risco. Este é um estudo de série de casos, longitudinal e intervencionista, em 100 lactentes, com idade entre 0-18 meses, provenientes de um ambulatório de risco. O desenvolvimento motor dos lactentes foi avaliado pela escala motora infantil de Alberta. Foram transmitidas orientações aos pais, a depender do atraso motor observado. Não houve relação dos fatores de risco com o desenvolvimento motor. Porém, esses fatores apresentaram relação com a idade gestacional, que teve, por sua vez, relação com o desenvolvimento motor. Após intervenção precoce parental, a frequência amostral aumentou de 45% para 69% no grupo de crianças com desenvolvimento motor normal. No grupo com atraso no desenvolvimento, a frequência amostral reduziu de 55% para 31%. Fatores de risco pré-natal e/ou perinatal podem acarretar prematuridade e consequentemente atraso no desenvolvimento motor infantil. Para esses lactentes, protocolos de intervenção precoce com atividades parentais são efetivos para promover um desenvolvimento motor normal de crianças em seguimento em ambulatório de risco.Por intermedio de actividades parentales, la intervención precoz en el desarrollo favorece logros cognitivos, físicos, sociales y emocionales a los bebés, factores determinantes para la salud infantil. Pero son pocos los estudios sobre la intervención precoz con actividades parentales. Así en este estudio se propone analizar los resultados de la intervención parental precoz para el desarrollo motor de lactantes en ambulatorio de una maternidad. Estudio de tipo serie de casos, longitudinal e intervencionista, del cual participaron cien lactantes, entre 0 y 18 meses de edad, provenientes del ambulatorio de la maternidad. Se evaluó el desarrollo motor de los lactantes por intermedio de la escala Alberta. Dependiendo del retraso motor observado en los bebés, se hicieron recomendaciones a los padres. No se encontró relaciones entre los factores de riesgo y el desarrollo motor. Sin embargo, estos factores presentaron relación con la edad gestacional, que se relacionó, a su vez, con el desarrollo motor. Tras la intervención precoz parental, la frecuencia del muestreo aumentó del 45% al 69% en el grupo de bebés con desarrollo motor normal. El grupo con retraso en el desarrollo sufrió una disminución en la frecuencia de la muestra del 55% al 31%. Los factores de riesgo prenatal y/o perinatal pueden implicar precocidad y, por consiguiente, retraso en el desarrollo motor infantil. Para lactantes en ambulatorios, estos protocolos de intervención precoz con actividades parentales son eficaces para promocionar su desarrollo motor normal.Early intervention based on parental activities promotes cognitive, physical, social, and emotional development, which are determinants for the child’s health. However, studies about early intervention with parental education are scarce. The objective of this study was to analyze the effect of parental intervention in the motor development of infants. This is a case series, longitudinal, and interventional study, with 100 infants at risk, aged 0-18 months. Motor development of infants was assessed by the Alberta Infant Motor Scale, and the parents received information about positioning and exercises depending on the child’s motor score. Risk factors were not related to infants’ motor development. However, these risk factors were related to gestational age, which was related to motor development. After parental early intervention, the sample frequency increased from 45% to 69% in the group of children with normal motor development. Frequency was reduced from 55% to 31% in the group with delayed development. Prenatal and/or perinatal risk factors can cause prematurity, and consequently, delays in children’s motor development. For these infants, early intervention protocols with parental education are effective to stimulate a normal motor development of children at risk in follow-up in outpatient clinics

Nanostructured system based on hydroxyapatite and curcumin: A promising candidate for osteosarcoma therapy:A promising candidate for osteosarcoma therapy

Osteosarcoma is the most common type of bone cancer. Despite therapeutic progress, survival rates for metastatic cases or that do not respond well to chemotherapy remain in the 30% range. In this sense, the use of nanotechnology to develop targeted and more effective therapies is a promising tool in the fight against cancer. Nanostructured hydroxyapatite, due to its biocompatibility and the wide possibility of functionalization, is an interesting material to design nanoplatforms for targeted drug delivery. These platforms have the potential to enable the use of natural substances in the fight against cancer, such as curcumin. Curcumin is a polyphenol with promising properties in treating various types of cancer, including osteosarcoma. In this work, hydroxyapatite (n-HA) nanorods synthesized by the hydrothermal method were investigated as a carrier for curcumin. For this, first-principle calculations based on the Density Functional Theory (DFT) were performed, in which the modification of curcumin (CM) with the coupling agent (3-aminopropyl) triethoxysilane (APTES) was theoretically evaluated. Curcumin was incorporated in n-HA and the drug loading stability was evaluated by leaching test. Samples were characterized by a multi-techniques approach, including Fourier transform infrared spectroscopy (FTIR), UV–visible spectroscopy (UV–Vis), X-ray diffraction (XRD), X-ray fluorescence spectrometry (FRX), thermogravimetric analysis (TGA), differential scanning calorimetry (DSC), zeta potential analysis (ζ), X-ray photoelectron spectroscopy (XPS) and transmission electron microscopy (TEM). The results show that n-HAs with a 90 nm average size were obtained and successful incorporation of curcumin in the nanostructure was achieved. Cell viability and the number of osteosarcoma cells were decreased by CMAP-HA treatment. Furthermore, the stability test suggests that hydroxyapatite nanoparticles present great potential for the transportation of curcumin in the bloodstream, crediting this system for biological performance evaluations aiming at the treatment of osteosarcomas. Keywords: nanostructures, curcumin, hydroxyapatite, osteosarcoma

Comparison of Anthropometric Profile and Cognitive Performance of Elite and Non-Elite Beach Volleyball Athletes

To compare the anthropometric profile and cognitive performance of elite and non-elite beach volleyball athletes. Comparative and descriptive study. The sample was composed by 8 athletes, divided in 2 groups: elite (n = 4) and non-elite (n = 4). They were evaluated in anthropometric parameters age, weight and height, and the variables of the cognitive performance evaluated by the battery of computerized tests CogState® (Brief Battery): Detection (Simple Reaction Time); Identification (Choice Reaction Time); One Back Speed (Working Memory); One Back Acuracy (Short Term Memory). Data were classified as non-parametric with the dispersion curve analysis performed by the Shapiro Wilk test. Anthropometric profile and cognitive performance variables were compared with the Mann Whitney U test between the groups. The procedures were performed with a significance level of p < 0.05 using the Statistical Package for the Social Science - SPSS®, Version 25.0. It was observed that there was significant difference in the anthropometric profile in the variable age (sig = 0.029) and in the cognitive performance significant differences occurred in the variables Detec (sig = 0.029) and Indent (sig = 0.029) of elite and not elite athletes of the beach volleyball modality. Elite and non-elite beach volleyball athletes present significant differences in the anthropometric variable (Age) and in the variables of cognitive performance (Detection and Identification) where elite athletes have a better cognitive performance than the non- elite athletes

Método canguru: percepção materna acerca da vivência na unidade de terapia intensiva neonatal

Objetivo: Conhecer a percepção materna acerca da vivência na primeira etapa do Método Canguru na Unidade de Terapia Intensiva Neonatal (UTIN). Métodos: Estudo descritivo, de caráter exploratório e de natureza qualitativa, realizado no período de agosto a outubro de 2014, com 10 mães de recém-nascidos pré-termo (RNPT) que se encontravam internados na Maternidade Escola Assis Chateaubriand (MEAC), Fortaleza-Brasil, e que haviam feito o contato pele a pele por meio do Método Canguru durante a internação na UTIN. Coletaramse os dados por entrevista semiestruturada, direcionados por questões norteadoras. Para tratamento dos dados, utilizou-se análise de conteúdo, sendo estabelecidas quatro categorias: “O vínculo e o apego”, “A competência materna”, “O medo da perda do bebê” e “A importância da equipe multidisciplinar”. Resultados: O Método Canguru é uma prática segura e prazerosa para mães e familiares, além de propiciar vantagens sociais e psicoafetivas que se encontram no imaginário da institucionalização do método e na experiência das mães quando adequadamente apoiadas. Pode-se evidenciar significados dos sentimentos maternos de insegurança em decorrência do primeiro contato físico com o filho hospitalizado. No tocante a avaliação de sua prática clínica, este vem proporcionando melhor desenvolvimento do neonato e uma diminuição do tempo de internação hospitalar. Conclusão: O estudo apresenta relevância, pois a visão da percepção materna no que concerne este método faz com que este se firme como prática obrigatória em maternidades, tendo em vista seus benefícios para mãe e neonato

Método canguru: percepção materna acerca da vivência na unidade de terapia intensiva neonatal

Objective: To investigate the maternal perception of the experience in the first phase of the Kangaroo Mother Care Method in the Neonatal Intensive Care Unit (NICU). Methods: Descriptive, exploratory and qualitative study, conducted in the period from August to October 2014, with 10 mothers of newborn preterm (NP) infants, who were admitted to the Maternity School Assis Chateaubriand (MEAC) in Fortaleza, Brazil, and had received skin-to-skin contact through the Kangaroo Care Method during hospitalization in the NICU. Data was collected by semi-structured interview, directed by guiding questions. Content analysis was used for processing the data, being established four categories: “The bond and the attachment”, “Maternal competence”, “The fear of losing the baby” and “The importance of the multidisciplinary team”. Results: The Kangaroo Care Method is a safe and pleasurable practice for mothers and relatives, in addition to providing social and psychoaffective benefits, found in the imagery of the method institutionalization and in the mothers’ experience when properly supported. The meanings of the maternal feelings of apprehension as a result of the first physical contact with the hospitalized child can be evidenced. Regarding the evaluation of its clinical practice, this method has provided better development of the newborn infant and a reduction in hospital stay. Conclusion: The study shows relevance, since the evidence of the maternal perception of this method supports its establishment as a mandatory practice in maternity hospitals, in view of the benefits to the mother and the neonate.Objetivo: Conocer la percepción materna sobre la vivencia de la primera fase/etapa del Método Canguro de la Unidad de Cuidados Intensivos Neonatal (UTIN). Métodos: Estudio descriptivo, de carácter exploratorio y naturaleza cualitativa realizado entre agosto y octubre de 2014 con 10 madres de recién nacidos pretermino (RNPT) que habían ingresado en La Maternidad Escuela Assis Chateaubriand (MEAC), Fortaleza- Brasil, las cuales habían tenido el contacto piel con piel a través del Método Canguro durante el período en la UTIN. Se recogió datos a través de la entrevista semi-estructurada orientados por cuestiones norteadoras. Se utilizó el Análisis de Contenido para el tratamiento de los datos del cual se estableció cuatro categorías: “El vínculo y el apego”, “La competencia materna”, “El miedo de perder el bebé” y “La importancia del equipo multidisciplinario”. Resultados: El Método Canguro es una práctica segura y placentera para madres y familiares además de proporcionar ventajas a nivel social y psicoafectivo de la imaginación de La institucionalización del método y de la experiencia de las madres con el apoyo adecuado. Se puede evidenciar significados de los sentimientos maternos de inseguridad decurrente del primer contacto físico con el hijo ingresado. Respecto la evaluación de su práctica clínica lo mismo ha proporcionado mejor desarrollo del neonato y la disminución del tiempo de ingreso hospitalario. Conclusión: El estudio es relevante puesto que la visión de la percepción materna sobre este método le caracteriza como uma práctica obligatoria de las maternidades por sus beneficios para la madre y el neonato.Objetivo: Conhecer a percepção materna acerca da vivência na primeira etapa do Método Canguru na Unidade de Terapia Intensiva Neonatal (UTIN). Métodos: Estudo descritivo, de caráter exploratório e de natureza qualitativa, realizado no período de agosto a outubro de 2014, com 10 mães de recém-nascidos pré-termo (RNPT) que se encontravam internados na Maternidade Escola Assis Chateaubriand (MEAC), Fortaleza-Brasil, e que haviam feito o contato pele a pele por meio do Método Canguru durante a internação na UTIN. Coletaramse os dados por entrevista semiestruturada, direcionados por questões norteadoras. Para tratamento dos dados, utilizou-se análise de conteúdo, sendo estabelecidas quatro categorias: “O vínculo e o apego”, “A competência materna”, “O medo da perda do bebê” e “A importância da equipe multidisciplinar”. Resultados: O Método Canguru é uma prática segura e prazerosa para mães e familiares, além de propiciar vantagens sociais e psicoafetivas que se encontram no imaginário da institucionalização do método e na experiência das mães quando adequadamente apoiadas. Pode-se evidenciar significados dos sentimentos maternos de insegurança em decorrência do primeiro contato físico com o filho hospitalizado. No tocante a avaliação de sua prática clínica, este vem proporcionando melhor desenvolvimento do neonato e uma diminuição do tempo de internação hospitalar. Conclusão: O estudo apresenta relevância, pois a visão da percepção materna no que concerne este método faz com que este se firme como prática obrigatória em maternidades, tendo em vista seus benefícios para mãe e neonato

Guidance on mucositis assessment from the MASCC Mucositis Study Group and ISOO: an international Delphi studyResearch in context

Summary: Background: Mucositis is a common and highly impactful side effect of conventional and emerging cancer therapy and thus the subject of intense investigation. Although common practice, mucositis assessment is heterogeneously adopted and poorly guided, impacting evidence synthesis and translation. The Multinational Association of Supportive Care in Cancer (MASCC) Mucositis Study Group (MSG) therefore aimed to establish expert recommendations for how existing mucositis assessment tools should be used, in clinical care and trials contexts, to improve the consistency of mucositis assessment. Methods: This study was conducted over two stages (January 2022–July 2023). The first phase involved a survey to MASCC-MSG members (January 2022–May 2022), capturing current practices, challenges and preferences. These then informed the second phase, in which a set of initial recommendations were prepared and refined using the Delphi method (February 2023–May 2023). Consensus was defined as agreement on a parameter by >80% of respondents. Findings: Seventy-two MASCC-MSG members completed the first phase of the study (37 females, 34 males, mainly oral care specialists). High variability was noted in the use of mucositis assessment tools, with a high reliance on clinician assessment compared to patient reported outcome measures (PROMs, 47% vs 3%, 37% used a combination). The World Health Organization (WHO) and Common Terminology Criteria for Adverse Events (CTCAE) scales were most commonly used to assess mucositis across multiple settings. Initial recommendations were reviewed by experienced MSG members and following two rounds of Delphi survey consensus was achieved in 91 of 100 recommendations. For example, in patients receiving chemotherapy, the recommended tool for clinician assessment in clinical practice is WHO for oral mucositis (89.5% consensus), and WHO or CTCAE for gastrointestinal mucositis (85.7% consensus). The recommended PROM in clinical trials is OMD/WQ for oral mucositis (93.3% consensus), and PRO-CTCAE for gastrointestinal mucositis (83.3% consensus). Interpretation: These new recommendations provide much needed guidance on mucositis assessment and may be applied in both clinical practice and research to streamline comparison and synthesis of global data sets, thus accelerating translation of new knowledge into clinical practice. Funding: No funding was received