Cytogenetics, JAK2 and MPL mutations in polycythemia vera, primary myelofibrosis and essential thrombocythemia

BACKGROUND: The detection of molecular and cytogenetic alterations is important for the diagnosis, prognosis and classification of myeloproliferative neoplasms. OBJECTIVE: The aim of this study was to detect the following mutations: JAK2 V617F, JAK2 exon 12 and MPL W515K/L, besides chromosomal abnormalities. Furthermore, molecular and cytogenetic alterations were correlated with the leukocyte and platelet counts, hemoglobin levels and age in all patients and with the degree of fibrosis in primary myelofibrosis cases. METHODS: Twenty cases of polycythemia vera, 17 of essential thrombocythemia and 21 of primary myelofibrosis were selected in the Hematology Department of the Universidade Federal de São Paulo (UNIFESP) between February 2008 and December 2009. The JAK2 V617F, JAK2 exon 12 mutations, MPL W515K and MPL W515L mutations were investigated by real-time PCR and direct sequencing. G-band karyotyping and fluorescence in situ hybridization were used to detect chromosomal abnormalities. RESULTS: Chromosomal abnormalities were observed only in polycythemia vera (11.8%) and primary myelofibrosis cases (17.6%), without correlation to clinical data. Chromosomal abnormalities were not detected by fluorescence in situ hybridization. The JAK2 V617F mutation was observed in polycythemia vera (90%), primary myelofibrosis (42.8%) and essential thrombocythemia (47%). Patients with JAK2 V617F-negative polycythemia vera had lower platelet and leukocyte counts compared to V617F-positive polycythemia vera (p-value = 0.0001 and p-value = 0.023, respectively). JAK2 V617F-positive and MPL W515L-positive primary myelofibrosis cases had a higher degree of fibrosis than V617F-negative cases (p-value = 0.022). JAK2 exon 12 mutations were not detected in polycythemia vera patients. The MPL W515L mutation was observed in one case of primary myelofibrosis and in one of essential thrombocythemia. The MPL W515K mutation was not found in patients with essential thrombocythemia or primary myelofibrosis. The MPL W515L-positive patient with primary myelofibrosis had more severe anemia than other patients with primary myelofibrosis. CONCLUSIONS: This study demonstrates that karyotyping for JAK2 and MPL mutations is useful in the diagnosis of myeloproliferative neoplasms. The precise pathogenetic contribution of these alterations is still unclear. However, this study adds more information about the pathophysiology of polycythemia vera, essential thrombocythemia and primary myelofibrosis.Universidade Federal de São Paulo (UNIFESP) Hematology DepartmentUniversidade Federal de São Paulo (UNIFESP) Rheumatology DepartmentUniversidade Federal de São Paulo (UNIFESP) Genetics DepartmentUNIFESP, Hematology DepartmentUNIFESP, Rheumatology DepartmentUNIFESP, Genetics DepartmentSciEL

Characteristics of resistance training-based protocols in older adults with sarcopenic obesity: a scoping review of training procedure recommendations

Background: Sarcopenic obesity (SO) is a clinical and functional disease characterized by the coexistence of obesity and sarcopenia. Resistance training (RT) characteristics for older adults with sarcopenia or obesity are already well established in the scientific literature. Nonetheless, we still do not know how detailed the RT protocols are described for older adults with SO. Therefore, we aimed to analyze the characteristics of RT programs, including each of their variables, recommended for older adults with SO. Methods: This is a scoping review study that was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Scoping Reviews. The search was carried out until November 2022 in PubMed/MEDLINE, EMBASE, Cochrane Library, Web of Science, Scopus, LILACS, Google Scholar, and medRxiv databases. The studies included SO diagnosis and RT as an intervention strategy. The RT variables analyzed were as follows: exercise selection, the volume of sets, the intensity of load, repetition cadence, rest interval between sets, and weekly frequency. Results: A total of 1,693 studies were identified. After applying the exclusion criteria, 15 studies were included in the final analysis. The duration of the RT intervention ranged from 8 to 24 weeks. All studies included full-body routines, with single/multi-joint exercises. Regarding the volume of sets, some studies fixed it in three sets, whereas others varied between one and three sets. The load was reported by repetition range and the weight lifted, elastic-band color/resistance, percentage of one repetition maximum, or perceived exertion scale. Repetition cadence was fixed in some studies, while it was self-selected between concentric and eccentric phases in others. The interval between sets of rest varied from 30 to 180 s. All studies reported progression overload during the interventions.info:eu-repo/semantics/publishedVersio

Estudo do amadurecimento de Carica Papaya utilizando lâmpadas de cultivo

Este trabalho, teve como objetivo avaliar a eficiência de lâmpadas de cultivo no amadurecimento de mamão. Foram utilizadas lâmpadas de cultivo indoor durante 72 horas de estudo; cada lâmpada contendo 80 LEDs, sendo 64 LEDs vermelhos (638 nm) e 16 LEDs azuis (468 nm). Foram analisadas a perda de massa fresca, Brix, pH, Acidez titulável e vitamina C. Os resultados mostraram que a exposição contínua dos mamões pelo período de 72 horas resultou em mamões maduros e saudáveis; este resultado foi comprovado a partir da mudança na coloração da casca e das análises físico-químicas realizadas na polpa dos frutos. Em todas as análises constatou-se que a utilização das lâmpadas de cultivo acelerou o processo de maturação dos mamões sem que ocorresse perda de nutrientes

DETERMINAÇÃO DOS COMPOSTOS FENÓLICOS TOTAIS EM CASCAS DE FRUTAS ENCONTRADAS NO CERRADO BRASILEIRO

O aumento da produção do setor agroindustrial, ao mesmo tempo em que proporciona benefícios econômicos e nutricionais ao homem, gera uma vasta quantidade de resíduos. Esses resíduos comumente descartados como casca, semente e talos contém uma grande quantidade de compostos bioativos como os compostos fenólicos. Nesse sentido o objetivo desse trabalho foi avaliar a eficácia de três soluções extratoras (água, etanol 80% e metanol 80%) e quantificar o teor de fenólicos totais em sete cascas de espécies de frutas exóticas brasileiras, guapeva (Pouteria gardneriana), jambolão (Syzygium cumini), pitaya (Hylocereus costaricensis), pupunha (Bactris gasipaes), oiti (Licania tomentosa), buriti (Mauritia flexuosa) e pitomba (Talisia esculenta), utilizando o método de Folin-Ciocalteou. A água mostrou-se a melhor solução extratora para as cascas analisadas. Os teores de compostos fenólicos variaram de 195,27 a 6,59 mg de EAG. 100g-1 de casca para o extrato aquoso, de 155 a 47,67 mg de EAG. 100g-1 de casca para as soluções etanólicas e de 192,57 a 1,35 mg de EAG. 100g-1 de casca para as soluções metanólicas. Sendo que os melhores resultados foram atribuídos as cascas de pitomba, buriti e guapeva. As cascas avaliadas neste estudo, podem ser consideradas boas fontes de compostos fenólicos totais

O avanço na assistência à pessoa com transtorno mental após a Reforma Psiquiátrica de 06 de abril de 2001

Objective: To describe the advance in assistance to people with mental disorders who are users of mental health after the Psychiatric Reform in Brazil.Objetivo: Descrever o avanço na assistência a pessoa com transtorno mental usuário de saúde mental após a Reforma Psiquiátrica no Brasil

Evaluation in vitro of antimicrobial activity of tucumã oil (Astrocaryum Vulgare)

Hospital Infection is a major health problem and affects around 1.5 million people annually around the world. The Amazon region has a wide diversity of native palm trees that have fruits and oilseeds. Astrocaryum vulgare, commonly known as Tucumã in Brazil, belongs to the family Arecaceae. This palm has orange, fleshy, single-egg-shaped fruits that are used for therapeutic purposes in diseases of the eyes and skin due to the high content of carotenoids, oil is used in cooking, health treatment and massage. This study evaluated the antimicrobial activity of the Tucumã oil against 18 microorganisms. The antimicrobial activity of Tucumã was measured through the determination of the Minimum Inhibitory Concentration (MIC), as well as the determination of the Minimum Microbicidal Concentration (CMM) aiming to contribute to the discovery of new antimicrobials against pathogenic microorganisms’ human health and may contribute to the treatment of nosocomial infections. The results showed that the oil of Tucumã presented antimicrobial activity against five important bacteria, four Gram - positive bacteria (Enterococcus faecalis, Enterococcus faecium, Staphylococcus epidermidis and Streptococcus agalactiae) and one Gram - negative (Acinetobacter baumannii)

Characteristics of resistance training-based protocols in older adults with sarcopenic obesity: a scoping review of training procedure recommendations

Background Sarcopenic obesity (SO) is a clinical and functional disease characterized by the coexistence of obesity and sarcopenia. Resistance training (RT) characteristics for older adults with sarcopenia or obesity are already well established in the scientific literature. Nonetheless, we still do not know how detailed the RT protocols are described for older adults with SO. Therefore, we aimed to analyze the characteristics of RT programs, including each of their variables, recommended for older adults with SO. Methods This is a scoping review study that was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Scoping Reviews. The search was carried out until November 2022 in PubMed/MEDLINE, EMBASE, Cochrane Library, Web of Science, Scopus, LILACS, Google Scholar, and medRxiv databases. The studies included SO diagnosis and RT as an intervention strategy. The RT variables analyzed were as follows: exercise selection, the volume of sets, the intensity of load, repetition cadence, rest interval between sets, and weekly frequency. Results A total of 1,693 studies were identified. After applying the exclusion criteria, 15 studies were included in the final analysis. The duration of the RT intervention ranged from 8 to 24 weeks. All studies included full-body routines, with single/multi-joint exercises. Regarding the volume of sets, some studies fixed it in three sets, whereas others varied between one and three sets. The load was reported by repetition range and the weight lifted, elastic-band color/resistance, percentage of one repetition maximum, or perceived exertion scale. Repetition cadence was fixed in some studies, while it was self-selected between concentric and eccentric phases in others. The interval between sets of rest varied from 30 to 180 s. All studies reported progression overload during the interventions. Not all studies reported how the exercise selection, repetition cadence, and rest interval were made. Conclusion The characteristics of RT protocols and their variables prescribed in the literature for older adults with SO were mapped. The lack of detail on some training variables (i.e., exercise selection, repetition cadence, and rest interval) was identified. RT protocols are heterogeneous and described only partially among studies. The recommendations for RT prescription details in older adults with SO are provided for future studies. Systematic review registration https://osf.io/wzk3d/

Cuidado Centrado na pessoa: reflexões da integração Ensino-Serviço na atenção básica

The National Curricular Guidelines for the Medical Course emphasize the strengthening of training in Primary Care, prioritizing person-centered care within the scope of health care. The objective of this study is to evaluate the impact of teaching-service integration on the development of this skill, through qualitative and quantitative research, using the Person-Centered Care Perception questionnaire. The research universe was composed of three groups: physicians with and without teaching-care activities and medical students in internship. The best results were obtained by professionals with a link to primary care, without teaching-care activities. The low performance of the interns suggests the need for strategies to bring the university closer to health services and ensure teaching qualifications, with a view to acquiring the necessary skills for medical students, for the development of good practices in person-centered care.Las Directrices Curriculares Nacionales de la Carrera de Medicina se centran en fortalecer la formación en Atención Primaria, priorizando, en el ámbito de la atención en salud, la atención centrada en la persona. El objetivo de este trabajo es evaluar el impacto de la integración enseñanza-servicio en el desarrollo de esta habilidad, a través de una investigación con enfoque cualitativo y cuantitativo, utilizando el cuestionario de Percepción de Atención Centrada en la Persona. El universo de la investigación estuvo conformado por tres grupos: médicos con y si actividad docente-asistencial y estudiantes de medicina en internado. Los mejores resultados los obtuvieron los profesionales que trabajan en atención primaria, sin actividades de asistencia docente. El bajo desempeño de los pasantes sugiere la necesidad de estrategias para acercar la universidad a los servicios de salud y garantizar la calificación docente, con miras a adquirir las habilidades necesarias para que los estudiantes de medicina desarrollen buenas prácticas en atención centrada en la persona.As Diretrizes Curriculares Nacionais do Curso de Medicina primam pelo fortalecimento da formação na Atenção Primária priorizando, no âmbito da atenção à saúde, o cuidado centrado na pessoa. O objetivo deste trabalho é avaliar o impacto da integração ensino-serviço para o desenvolvimento dessa habilidade, através  de pesquisa de abordagem qualitativa e quantitativa, utilizando o questionário de Percepção do Cuidado Centrado na Pessoa. O universo da pesquisa foi composto por três grupos: médicos com e sem atividade docente-assistencial e alunos de medicina no internato. Os melhores resultados foram obtidos pelos profissionais com vínculo na atenção primária, sem atividade docente assistencial. O baixo desempenho dos internos sugere a necessidade  de estratégias para aproximar a universidade dos serviços de saúde e garantir a qualificação docente, com vistas à aquisição de habilidades necessárias aos estudantes de medicina, para o desenvolvimento  de boas práticas de cuidado centrado na pessoa

Fatores comportamentais associam-se com a prática de atividade física/exercício de idosos hipertensos

INTRODUCTION: The non-medicated treatment for arterial hypertension involves changes in lifestyle. Physical activity (PA) and physical exercise (PE) regularly practiced can control arterial hypertension, decreasing global cardiovascular risk. However, the assiduity of hypertensive older people in PE programs and PA still look reduced. The variables that can explain this issue are not yet known. OBJECTIVE: To verify if the adequate practice of exercise and physical activity are associated with nutritional status, health risk behaviors, and eating habits in older hypertensive adults. METHODS: older hypertensive adults (n=10.789) with a mean age of 70.9±7.4 years old from the database of study of surveillance of risk and protection factors for chronic diseases by telephone survey -VIGITEL were classified as practicians (1) or not-practicians (0) of PE and if they were sufficiently actives (1) insufficiently actives (0). Binary logistic regression tested the odds ratio (OR) between the dependent variables (PE practice and PA classification) to be associated with the independent variables (nutritional status with body mass index [BMI], health risk behaviors with screen time ≥3 hours/day, alcohol, and tobacco consumption; both answered in a dichotomous way [yes/no] and eating habits [consumption of minimally processed and ultra-processed food scores]. RESULTS: the probability of practicing PE and achieving sufficient levels of PA are increased for each score derived from minimally processed food consumed (OREF=16.8%; ORAF=13.2%, respectively; p<0.05). The same probabilities are reduced when they are higher nutritional status (ORPE=-2.1%; ORPA=-2.7%), screen time (ORAF=-10.2%), alcohol (ORPE=-29.4%; ORPA=-31.1%) and tobacco (ORPE=-53.2%; ORPA=-38.4%) consumption are confirmed and for each score consumed more of ultra-processed food (ORPE=-11.2%; ORPA=-10.1%). CONCLUSION: The practice of PE and being sufficiently active in older hypertensive adults seems to be related to an adequate nutritional status, less frequency of health risk behaviors, and eating habits inadequate.  Objective strategies in an attempt to modify the behavioral risk factors that interfere with the control of arterial hypertension in older adults can be adopted to improve the assiduity of hypertensive older people in body movements.INTRODUCCIÓN: El tratamiento no farmacológico de la hipertensión arterial implica la modificación del estilo de vida. La actividad física (AF) regular y ejercicio físico (EF) pueden controlar la hipertensión arterial, reduciendo el riesgo cardiovascular global. Sin embargo, la asistencia de ancianos hipertensos a los programas de EF y AF todavía parece reducida. Las variables que pueden explicar este problema aún no se conocen. OBJETIVO: Verificar si el ejercicio físico adecuado y la actividad física están asociados con el estado nutricional, las conductas de riesgo para la salud y los hábitos alimentarios en ancianos hipertensos. MÉTODOS: ancianos hipertensos (n=10.789) con edad media de 70,9±7,4 años de la base de datos del estudio de vigilancia de factores de riesgo y protección para enfermedades crónicas por encuesta telefónica-VIGITEL fueron clasificados como practicantes (1) o no practicantes (0) de EF (0) y si eran suficientemente activos (1) o insuficientemente activos (0). La regresión logística binaria probó el odds ratio (OR) de las variables dependientes (práctica de EF y clasificación de AF) para asociarlas con las variables independientes (estado nutricional con índice de masa corporal [IMC], comportamientos de riesgo con tiempo de pantalla ≥3 horas/día, consumo de alcohol y tabaco; ambos respondieron dicotómicamente [sí/no] y hábitos alimentarios [puntuación de consumo de alimentos mínimamente procesados ​​y ultraprocesados]). RESULTADOS: la probabilidad de practicar EF y alcanzar niveles suficientes de AF aumenta por cada puntuación derivada del consumo de alimentos mínimamente procesados ​​(OREF=16,8%; ORAF=13,2%, respectivamente; p<0,05). Las mismas probabilidades se reducen con mayor estado nutricional (mayor IMC) (OREF=-2,1%; ORAF=-2,7%), tiempo de pantalla (ORAF=-10,2%), consumo de alcohol (OREF=-29,4%; ORAF= -31,1 %) y tabaco (OREF=-53,2 %; ORAF=-38,4 %) se confirman y por cada puntaje consumen más alimentos ultraprocesados ​​(OREF=-11,2 %; ORAF=-10,1 %).CONCLUSIÓN: La práctica de EF y ser suficientemente activo en ancianos hipertensos parece estar relacionada con adecuado estado nutricional, menor frecuencia de conductas de riesgo para la salud y los hábitos alimentarios inadecuados. Se pueden adoptar estrategias objetivas en el intento de modificar los factores de riesgo conductuales que interfieren en el control de la hipertensión arterial en los ancianos para mejorar la asiduidad de los ancianos hipertensos en los movimientos corporales.INTRODUÇÃO: O tratamento não medicamentoso da hipertensão arterial envolve modificação do estilo de vida. A atividade física (AF) e exercício físico (EF) praticados de forma regular podem controlar a hipertensão arterial, reduzindo o risco cardiovascular global. Todavia, a assiduidade de idosos hipertensos em programas de EF e AF ainda parece reduzida. Ainda não se conhecem as variáveis que podem explicar essa questão. OBJETIVO: Verificar se a prática adequada de exercício físico e atividade física está associada com o estado nutricional, os comportamentos de risco à saúde e os hábitos alimentares em idosos hipertensos. MÉTODOS: idosos hipertensos (n=10.789) com média de idade de 70,9±7,4 anos do banco de dados do estudo de vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico-VIGITEL foram classificados praticantes (1) ou não praticantes (0) de EF e se eram suficientemente ativos (1) ou insuficientemente ativos (0). A regressão logística binária testou a razão de chances (OR) das variáveis dependentes (prática de EF e classificação de AF) se associarem com as independentes (estado nutricional com o índice de massa corporal [IMC], comportamentos de risco com o tempo de tela ≥3horas/dia, consumo de álcool e tabaco; ambos respondidos dicotomicamente [sim/não] e hábitos alimentares [escore do consumo de alimentos minimamente processados e ultraprocessados]). RESULTADOS: a probabilidade praticar EF e de conseguir atingir níveis suficientes de AF são aumentadas para cada escore derivado de alimento minimamente processado consumido (OREF=16,8%; ORAF=13,2%, respectivamente; p<0,05). As mesmas probabilidades são reduzidas quando são maiores o estado nutricional (OREF=-2,1%; ORAF=-2,7%), o tempo de tela (ORAF=-10,2%), o consumo de álcool (OREF=-29,4%; ORAF=-31,1%) e tabaco (OREF=-53,2%; ORAF=-38,4%) são confirmados e para cada escore consumido a mais de alimento ultraprocessado (OREF=-11,2%; ORAF=-10,1%). CONCLUSÃO: A prática de EF e ser suficientemente ativo em idosos hipertensos parece ter relação com o estado nutricional adequado, menor frequência de comportamentos de risco à saúde e de hábitos alimentares inadequados. Estratégias objetivas na tentativa de modificar os fatores de risco comportamentais que interferem no controle da hipertensão arterial em idosos podem ser adotados para melhorar a assiduidade dos idosos hipertensos nos movimentos corporais