Considerações sobre fenilcetonúria- Vivência clínica do Hospital Infantil Albert Sabin / Considerations about Phenylketonuria- Clinical experience at Hospital Infantil Albert Sabin

A fenilcetonúria (PKU) é uma doença genética rara (1: 13.500- 21.000 nascidos vivos), apesar de considerada o erro inato de metabolismo mais comum (BRASIL, 2005). A doença é decorrente da incapacidade da enzima fenilalanina hidroxilase converter fenilalanina (PHE) em tirosina (TYR) e assim a fenilalanina e outros metabólitos se acumulam, a tirosina é reduzida e essas alterações causam repercussões sistêmicas. (NETO, 2021, p.20)Conforme NETO (2021) o diagnóstico da PKU deve ser preferencialmente realizado no período neonatal, antes do aparecimento dos sintomas clínicos, uma vez que a lesão neurológica é irreversível.Com o aumento do conhecimento sobre PKU, ficou óbvio que o tratamento deveria ser o mais precoce possível e, aliado ao surgimento dos exames em papel filtro, que caracterizaram a triagem neonatal, foi transformada a história natural da PKU a ponto de não se aceitar que uma criança não faça triagem neonatal e que não tenha terapia para PKU no Brasil, já que é universalizada e gratuita para todas as crianças do país através do sistema único de saúde (SUS). (MENDES, et. Al. 2019, p. 18)A falta da terapia por negligência da família pode ser considerada maus tratos à criança com consequências da lei nº 9.605, de 12 de fevereiro de 1998, ao qual a mesma ressalta ainda sobre a perda da guarda da criança como consequência.No Hospital Infantil Albert Sabin (HIAS) a triagem neonatal para fenilcetonúria e hipotireoidismo congênito iniciou após a publicação da Portaria GM/MS nº 822 do Ministério da Saúde (6/06/2001). O HIAS foi escolhido para ser centro de referência em triagem neonatal por ser um hospital de referência para os programas do ministério da saúde em que há emergência, cirurgia, enfermaria, UTI, ambulatório e todos os especialistas da equipe multidisciplinar que atendem crianças e adolescentes até 18 anos de idade de todo estado do Ceará. Assim, iniciou o ambulatório especializado para crianças com alterações na triagem neonatal. (NETO, 2021, p.27).Apresentamos a caracterização da dietoterapia na fenilcetonúria no Hospital Infantil Albert Sabin.

P2X7 receptor contributes to long-term neuroinflammation and cognitive impairment in sepsis-surviving mice

Introduction: sepsis is defined as a multifactorial debilitating condition with high risks of death. The intense inflammatory response causes deleterious effects on the brain, a condition called sepsis-associated encephalopathy. Neuroinflammation or pathogen recognition are able to stress cells, resulting in ATP (Adenosine Triphosphate) release and P2X7 receptor activation, which is abundantly expressed in the brain. The P2X7 receptor contributes to chronic neurodegenerative and neuroinflammatory diseases; however, its function in long-term neurological impairment caused by sepsis remains unclear. Therefore, we sought to evaluate the effects of P2X7 receptor activation in neuroinflammatory and behavioral changes in sepsis-surviving mice. Methods: sepsis was induced in wild-type (WT), P2X7−/− , and BBG (Brilliant Blue G)-treated mice by cecal ligation and perforation (CLP). On the thirteenth day after the surgery, the cognitive function of mice was assessed using the novel recognition object and Water T-maze tests. Acetylcholinesterase (AChE) activity, microglial and astrocytic activation markers, and cytokine production were also evaluated. Results: Initially, we observed that both WT and P2X7−/− sepsis-surviving mice showed memory impairment 13 days after surgery, once they did not differentiate between novel and familiar objects. Both groups of animals presented increased AChE activity in the hippocampus and cerebral cortex. However, the absence of P2X7 prevented partly this increase in the cerebral cortex. Likewise, P2X7 absence decreased ionized calcium-binding protein 1 (Iba−1 ) and glial fibrillary acidic protein (GFAP) upregulation in the cerebral cortex of sepsis-surviving animals. There was an increase in GFAP protein levels in the cerebral cortex but not in the hippocampus of both WT and P2X7−/− sepsis-surviving animals. Pharmacological inhibition or genetic deletion of P2X7 receptor attenuated the production of Interleukin-1β (IL-1β), Tumor necrosis factor-α (TNF-α), and Interleukin-10 (IL-10). Conclusion: the modulation of the P2X7 receptor in sepsis-surviving animals may reduce neuroinflammation and prevent cognitive impairment due to sepsisassociated encephalopathy, being considered an important therapeutic target

Nutritional value and kinetics of in vitro fermentation of spineless cactus of the genus Nopalea in different phenological phases

Abstract The objective was to evaluate the chemical composition and in vitro fermentation of spineless cactus of the genus Nopalea, F-21 (Nopalea cochenillifera Dyck), IPA-Sertânia (Nopalea cochenillifera Dyck) and Miúda (Nopalea cochenillifera Salm Dyck), in different phenophases. There was no effect (P < 0.05) of the phenological phases of spineless cactus on DM, ash, OM, EE, and CP. Varieties F-21 and Miúda presented higher values of DM and OM, whereas the CP was higher for IPA-Sertânia. The contents of NDF, ADF, and ADL, as well as the fractions of carbohydrates B2 and C were higher in the mature stage, irrespective of the variety. The Miúda variety showed higher levels of NFC and fractions A + B1 and the lower levels of pectin compared to the F-21 and IPA-Sertânia varieties, but not differ of TC to F-21. The volume of gas produced via the degradation of NFC was higher for young phenological phases. The young and intermediate stages showed a higher in vitro digestibility of DM. Based on the results, varieties IPA-Sertânia and Miúda have a high potential for use in animal feed because of their high nutritional quality. Mature cladodes showed a higher fibrous fraction and lower digestibility in all varieties

Antioxidant Activity and Stable Free Radicals in Robusta Green Coffee Genotypes/ Atividade antioxidante e Radicais Estáveis Livres em Genótipos de Café Verde Robusta

This study reports on physicochemical properties (total soluble solids, titratable acidity plus caffeine, trigonelline, 5-CQA, and total phenols contents) of five genotypes of Robusta coffee beans; Bamburral, Beira Rio, Clementino, Coringa, and Pirata. Green bean of Clementino presents the highest concentration of total soluble solids in dry basis (18.0%) and the lowest titratable acidity (154.0 mL-NaOH). Moreover, green beans of Clementino and Pirata show intermediate values of caffeine and trigonelline contents while presenting the highest yield index ofstable free radical formation after roasting, respectively equal to 26 and 23 (electron paramagnetic resonance-EPR data), and the highest content of 5-CQA (around 42 mg/g). Green beans of Bamburral, Beira Rio and Coringa show the highest concentration of total phenols (53 - 56 mg/g), meaning the highest antioxidant activities (IC50 test) but reduced yield index of formation of stable free radicals after roasting, respectively equal to 13.0, 5.9, and 13.0 (EPR data)