A smoking prevention program delivered by medical students to secondary schools in Brazil called ?Education Against Tobacco? : randomized controlled trial.

Background: Smoking is the largest preventable cause of mortality in Brazil. Education Against Tobacco (EAT) is a network of more than 3500 medical students and physicians across 14 countries who volunteer for school-based smoking prevention programs. EAT educates 50,000 adolescents per year in the classroom setting. A recent quasi-experimental study conducted in Germany showed that EAT had significant short-term smoking cessation effects among adolescents aged 11 to 15 years. Objective: The aim is to measure the long-term effectiveness of the most recent version of the EAT curriculum in Brazil. Methods: A randomized controlled trial was conducted among 2348 adolescents aged 12 to 21 years (grades 7-11) at public secondary schools in Brazil. The prospective experimental design included measurements at baseline and at 6 and 12 months postintervention. The study groups comprised randomized classes receiving the standardized EAT intervention (90 minutes of mentoring in a classroom setting) and control classes in the same schools (no intervention). Data were collected on smoking status, gender, social aspects, and predictors of smoking. The primary endpoint was the difference in the change in smoking prevalence between the intervention group and the control group at 12-month follow-up. Results: From baseline to 12 months, the smoking prevalence increased from 11.0% to 20.9% in the control group and from 14.1% to 15.6% in the intervention group. This difference was statistically significant (P<.01). The effects were smaller for females (control 12.4% to 18.8% vs intervention 13.1% to 14.6%) than for males (control 9.1% to 23.6% vs intervention 15.3% to 16.8%). Increased quitting rates and prevented onset were responsible for the intervention effects. The differences in change in smoking prevalence from baseline to 12 months between the intervention and control groups were increased in students with low school performance. Conclusions: To our knowledge, this is the first randomized trial on school-based tobacco prevention in Brazil that shows significant long-term favorable effects. The EAT program encourages quitting and prevents smoking onset, especially among males and students with low educational background

Achados ecodopplercardiográficos, eletrocardiográficos, radiográficos e pressão arterial em cães obesos / Doppler echocardiographic, electrocardiographic, radiographic and blood pressure findings in obese dogs

A obesidade em cães é considerada comum na prática veterinária. Nos últimos anos, estima-se que animais acima do peso apresentaram uma significativa elevação quando se diz respeito a animais de companhia, onde os índices de obesidade divulgados chegam a estar entre 24% e 44% nos cães. Diversos estudos vêm mostrando o quanto as alterações no sistema cardiovascular de cães se mostram relacionadas à essa obesidade. Exames como o eletrocardiograma, ecodopplercardiograma e exames radiográficos, tornaram-se técnicas fundamentais no auxílio da identificação das doenças cardíacas em Medicina Veterinária, onde há relatos crescentes dessa patologia, seja ela de origem congênita ou adquirida. Alguns fatores hormonais endócrinos podem causar obesidade e problemas relacionados ao sistema cardíaco dos cães, ocasionando assim mudanças negativas na atividade elétrica, contratilidade do miocárdio, funções sistólica e diastólica e frequência cardíaca. Todas essas mudanças podem ocasionar alterações importantes e de risco para o animal, devendo ser devidamente e minuciosamente avaliada. 

Controle de qualidade e parâmetros microbiológicos em rações comerciais para cães e gatos / Quality control and microbiological parameters in commercial dog and cat food

A qualidade e segurança biológica das rações para cães e gatos abrangem o controle de diferentes segmentos da produção, desde os procedimentos empregados na agricultura para desenvolvimento de plantas saudáveis, a produção industrial, o transporte do produto final até o armazenamento nos pontos de venda e consumo em residências. Além da possibilidade de contaminação microbiana, o crescimento fúngico e as micotoxinas são substâncias que podem acarretar danos aos animais. O fortalecimento do vínculo humano-animal tem impulsionado a preocupação com o bem-estar dos animais de companhia, bem como com a qualidade e segurança dos alimentos destinados aos animais. Há a necessidade de se produzir alimentos com maior prazo de validade, devido às necessidades de produção das fábricas ou mesmo de logística de entrega nos estabelecimentos comerciais, na qual a microbiota fúngica exerce maior influência na conservação das rações. O objetivo deste trabalho é revisar parâmetros de segurança microbiológica em rações comerciais

A Face-Aging App for Smoking Cessation in a Waiting Room Setting: Pilot Study in an HIV Outpatient Clinic

Background: There is strong evidence for the effectiveness of addressing tobacco use in health care settings. However, few smokers receive cessation advice when visiting a hospital. Implementing smoking cessation technology in outpatient waiting rooms could be an effective strategy for change, with the potential to expose almost all patients visiting a health care provider without preluding physician action needed. Objective: The objective of this study was to develop an intervention for smoking cessation that would make use of the time patients spend in a waiting room by passively exposing them to a face-aging, public morphing, tablet-based app, to pilot the intervention in a waiting room of an HIV outpatient clinic, and to measure the perceptions of this intervention among smoking and nonsmoking HIV patients. Methods: We developed a kiosk version of our 3-dimensional face-aging app Smokerface, which shows the user how their face would look with or without cigarette smoking 1 to 15 years in the future. We placed a tablet with the app running on a table in the middle of the waiting room of our HIV outpatient clinic, connected to a large monitor attached to the opposite wall. A researcher noted all the patients who were using the waiting room. If a patient did not initiate app use within 30 seconds of waiting time, the researcher encouraged him or her to do so. Those using the app were asked to complete a questionnaire. Results: During a 19-day period, 464 patients visited the waiting room, of whom 187 (40.3%) tried the app and 179 (38.6%) completed the questionnaire. Of those who completed the questionnaire, 139 of 176 (79.0%) were men and 84 of 179 (46.9%) were smokers. Of the smokers, 55 of 81 (68%) said the intervention motivated them to quit (men: 45, 68%;women: 10, 67%);41 (51%) said that it motivated them to discuss quitting with their doctor (men: 32, 49%;women: 9, 60%);and 72 (91%) perceived the intervention as fun (men: 57, 90%;women: 15, 94%). Of the nonsmokers, 92 (98%) said that it motivated them never to take up smoking (men: 72, 99%;women: 20, 95%). Among all patients, 102 (22.0%) watched another patient try the app without trying it themselves;thus, a total of 289 (62.3%) of the 464 patients were exposed to the intervention (average waiting time 21 minutes). Conclusions: A face-aging app implemented in a waiting room provides a novel opportunity to motivate patients visiting a health care provider to quit smoking, to address quitting at their subsequent appointment and thereby encourage physician-delivered smoking cessation, or not to take up smoking

A skin cancer prevention facial-aging mobile app for secondary schools in Brazil : appearance-focused interventional study.

Background: The incidence of melanoma is increasing faster than any other major cancer both in Brazil and worldwide. Southeast Brazil has especially high incidences of melanoma, and early detection is low. Exposure to ultraviolet (UV) radiation is a primary risk factor for developing melanoma. Increasing attractiveness is a major motivation among adolescents for tanning. A medical student-delivered intervention that takes advantage of the broad availability of mobile phones and adolescents? interest in their appearance indicated effectiveness in a recent study from Germany. However, the effect in a high-UV index country with a high melanoma prevalence and the capability of medical students to implement such an intervention remain unknown. Objective: In this pilot study, our objective was to investigate the preliminary success and implementability of a photoaging intervention to prevent skin cancer in Brazilian adolescents. Methods: We implemented a free photoaging mobile phone app (Sunface) in 15 secondary school classes in southeast Brazil. Medical students ?mirrored? the pupils? altered 3-dimensional (3D) selfies reacting to touch on tablets via a projector in front of their whole grade accompanied by a brief discussion of means of UV protection. An anonymous questionnaire capturing sociodemographic data and risk factors for melanoma measured the perceptions of the intervention on 5-point Likert scales among 356 pupils of both sexes (13-19 years old; median age 16 years) in grades 8 to 12 of 2 secondary schools in Brazil. Results: We measured more than 90% agreement in both items that measured motivation to reduce UV exposure and only 5.6% disagreement: 322 (90.5%) agreed or strongly agreed that their 3D selfie motivated them to avoid using a tanning bed, and 321 (90.2%) that it motivated them to improve their sun protection; 20 pupils (5.6%) disagreed with both items. The perceived effect on motivation was higher in female pupils in both tanning bed avoidance (n=198, 92.6% agreement in females vs n=123, 87.2% agreement in males) and increased use of sun protection (n=197, 92.1% agreement in females vs n=123, 87.2% agreement in males) and independent of age or skin type. All medical students involved filled in a process evaluation revealing that they all perceived the intervention as effective and unproblematic, and that all pupils tried the app in their presence. Conclusions: The photoaging intervention was effective in changing behavioral predictors for UV protection in Brazilian adolescents. The predictors measured indicated an even higher prospective effectiveness in southeast Brazil than in Germany (>90% agreement in Brazil vs >60% agreement in Germany to both items that measured motivation to reduce UV exposure) in accordance with the theory of planned behavior. Medical students are capable of complete implementation. A randomized controlled trial measuring prospective effects in Brazil is planned as a result of this study

Facial-aging mobile apps for smoking prevention in secondary schools in Brazil : appearance-focused interventional study.

Background: Most smokers start smoking during their early adolescence, often with the idea that smoking is glamorous. Interventions that harness the broad availability of mobile phones as well as adolescents' interest in their appearance may be a novel way to improve school-based prevention. A recent study conducted in Germany showed promising results. However, the transfer to other cultural contexts, effects on different genders, and implementability remains unknown. Objective: In this observational study, we aimed to test the perception and implementability of facial-aging apps to prevent smoking in secondary schools in Brazil in accordance with the theory of planned behavior and with respect to different genders. Methods: We used a free facial-aging mobile phone app (?Smokerface?) in three Brazilian secondary schools via a novel method called mirroring. The students? altered three-dimensional selfies on mobile phones or tablets and images were ?mirrored? via a projector in front of their whole grade. Using an anonymous questionnaire, we then measured on a 5-point Likert scale the perceptions of the intervention among 306 Brazilian secondary school students of both genders in the seventh grade (average age 12.97 years). A second questionnaire captured perceptions of medical students who conducted the intervention and its conduction per protocol. Results: The majority of students perceived the intervention as fun (304/306, 99.3%), claimed the intervention motivated them not to smoke (289/306, 94.4%), and stated that they learned new benefits of not smoking (300/306, 98.0%). Only a minority of students disagreed or fully disagreed that they learned new benefits of nonsmoking (4/306, 1.3%) or that they themselves were motivated not to smoke (5/306, 1.6%). All of the protocol was delivered by volunteer medical students. Conclusions: Our data indicate the potential for facial-aging interventions to reduce smoking prevalence in Brazilian secondary schools in accordance with the theory of planned behavior. Volunteer medical students enjoyed the intervention and are capable of complete implementation per protocol

Síntese de novas 1,3-benzoxatiol-2-onas contendo o sistema 1,3-tiazolidin-4-ona com potencial atividade antitumoral

Os heterociclos compõem uma classe de substâncias que desperta grande interesse sintético devido a sua ampla aplicação em diversos setores da indústria química e farmacêutica. Em especial, derivados contendo os sistemas 1,3-benzoxatiol-2-onas e as 1,3-tiazolidin-4-onas vêm sendo descritos por suas importantes atividades biológicas. Dentro deste contexto, este trabalho descreve a síntese de quatro derivados tiazolidinônicos (13a-d) e três derivados tiazolidinônicos etilados (14a, 14c-d) contendo o núcleo 1,3-benzoxatiol-2-ona, inéditos na literatura, com potencial atividade antitumoral. A primeira etapa da síntese consistiu em uma reação de substituição eletrofílica aromática seguido de ciclização intramolecular envolvendo o resorcinol (9), tiocianato de potássio e sulfato de cobre II, resultando na obtenção do intermediário imino-tiocarbonato 10 com rendimento bruto de 76 %. Na segunda etapa, o intermediário 10 foi submetido a uma reação de hidrólise utilizando solução de HCl 10 %, promovendo a obtenção da 6-hidroxi-1,3-benzoxatiol-2-ona (2) com 57 % de rendimento. Na terceira etapa, o intermediário 2 foi submetido a uma reação de nitração, em diclorometano, utilizando solução de HNO3 65 %, obtendo-se o intermediário 4 com 71 % de rendimento. O intermediário nitrado 4 foi posteriormente submetido à hidrogenação catalítica em suporte de Pd/C 10 %, levando à formação do intermediário amino 16 com 85 % de rendimento. Os derivados 13a-d foram sintetizados através de metodologia one-pot, envolvendo reações de condensação entre o intermediário 16 e benzaldeídos substituídos, e posteriormente reações das respectivas iminas com ácido mercaptoacético seguido de ciclização intramolecular. O rendimento das reações variou de 20 a 51 %, após otimização da metodologia. Por fim, os derivados 14a, 14c-d foram obtidos com rendimentos entre 51-54 %, após etilação da hidroxila fenólica das substâncias 13a, 13c-d mediante reação, em DMF, com brometo de etila em presença de K2CO3. As substâncias sintetizadas foram caracterizadas por medições de pontos de fusão, espectroscopia na região do infravermelho e ressonância magnética nuclear de hidrogênio. Os novos heterociclos (13a-d e 14a, 14c-d) estão sendo submetidos a estudos para avaliação da atividade antitumoral frente a diferentes linhagens de células cancerígenas.Heterocycles make up a class of substances that arouses great synthetic interest due to their wide application in various sectors of the chemical and pharmaceutical industry. In particular, derivatives containing the 1,3-benzoxathiol-2-one and 1,3-thiazolidin-4-one systems have been described for their important biological activities. In this context, this work describes the synthesis of four thiazolidinonic derivatives (13a-d) and three ethylated thiazolidinonic derivatives (14a, 14c-d) containing the 1,3-benzoxathiol-2-one nucleus, unpublished in the literature, with potential antitumor activity. The first step of the synthesis consisted of an aromatic electrophilic substitution reaction followed by intramolecular cyclization involving resorcinol (9), potassium thiocyanate and copper sulfate II, resulting in the imino-thiocarbonate intermediate 10 with a gross yield of 76 %. In the second step, intermediate 10 was subjected to a hydrolysis reaction using 10 % HCl solution, promoting the obtaining of 6-hydroxy-1,3-benzoxathiol-2-one (2) with 57 % yield. In the third step, intermediate 2 was subjected to a nitration reaction, in dichloromethane, using 65 % HNO3 solution, obtaining intermediate 4 with 71 % yield. Intermediate 4 was subsequently subjected to catalytic hydrogenation in 10 % Pd/C support, leading to the formation of amino intermediate 16 with 85 % yield. Derivatives 13a-d were synthesized through one-pot methodology involving condensation reactions between intermediate 16 and substituted benzaldehydes, and subsequently reactions of their respective imines with mercaptoacetic acid followed by intramolecular cyclization. The reaction yield varied from 20 to 51 %, after optimization of the methodology. Finally, derivatives 14a, 14c-d were obtained with 51-54 % yields, after ethylation of the phenolic hydroxyl of substances 13a, 13c-d by reaction, in DMF, with ethyl bromide in the presence of K2CO3. The synthesized substances were characterized by melting point measurements and spectroscopic analysis in infrared region and hydrogen nuclear magnetic resonance. The new heterocycles (13a-d and 14a, 14c-d) are being subjected to studies to assess antitumor activity against different cancer cell lines

Late-Onset Infection in a Leadless&nbsp;Pacemaker

Infection of leadless pacemakers (LPM) is rare, even in patients at high risk for infections. Only 3 cases of LPM infection have been documented in the literature, all occurring within 1&nbsp;month of device implantation. We report the first case, to our knowledge, of late-onset LPM infection, developing almost 2 years after implantation. (Level of Difficulty: Beginner.)