Ingestion of Non-digestible Carbohydrates From Plant-Source Foods and Decreased Risk of Colorectal Cancer: A Review on the Biological Effects and the Mechanisms of Action

The hypothesis that links the increase in the intake of plant-source foods to a decrease in colorectal cancer (CRC) risk has almost 50 years. Nowadays, systematic reviews and meta-analysis of case-control and cohort studies confirmed the association between dietary patterns and CRC risk, in which the non-digestible carbohydrates (NDC) from plant-source foods are known to play beneficial effects. However, the mechanisms behind the physicochemical properties and biological effects induced by NDC on the decrease of CRC development and progression remain not fully understood. NDC from plant-source foods consist mainly of complex carbohydrates from plant cell wall including pectin and hemicellulose, which vary among foods in structure and in composition, therefore in both physicochemical properties and biological effects. In the present review, we highlighted the mechanisms and described the recent findings showing how these complex NDC from plant-source foods are related to a decrease in CRC risk through induction of both physicochemical effects in the gastrointestinal tract, fermentation-related effects, and direct effects resulting from the interaction between NDC and cellular components including toll-like receptors and galectin-3. Studies support that the definition of the structure-function relationship—especially regarding the fermentation-related effects of NDC, as well as the direct effects of these complex carbohydrates in cells—is crucial for understanding the possible NDC anticancer effects. The dietary recommendations for the intake of NDC are usually quantitative, describing a defined amount of intake per day. However, as NDC from plant-source foods can exert effects that vary widely according to the NDC structure, the dietary recommendations for the intake of NDC plant-source foods are expected to change from a quantitative to a qualitative perspective in the next few years, as occurred for lipid recommendations. Thus, further studies are necessary to define whether specific and well-characterized NDC from plant-source foods induce beneficial effects related to a decrease in CRC risk, thereby improving nutritional recommendations of healthy individuals and CRC patients

Epilepsy Detection Using Artificial Neural Networks

Epilepsy is a neurological disorder, where there is a cluster of brain cells that behave in a hyperexcitable manner, the individual can promote injuries, trauma or, in more severe cases, sudden death. Electroencephalogram (EEG) is the most used way to detect epileptic seizures. Therefore, more simplified methods of analysis of the EEG can help in the diagnosis and treatment of these individuals more quickly. In this study, we extracted pertinent EEG characteristics to assess the epileptic seizure period. We use Perceptron Multilayer artificial neural networks to classify the period of the crisis, obtaining a more efficient diagnosis. The multilayer neural network obtained an accuracy of 98%. Thus, the strategy of extracting characteristics and the architecture of the assigned network were sufficient for a rapid and accurate diagnosis of epilepsy

Aquagenic Plantar Keratoderma: A Case Report

A queratodermia aquagénica é uma doença adquirida rara, predominante em pacientes jovens do sexo feminino, acometendo, principalmente, palmas e, mais raramente, as plantas dos pés. Clinicamente, apresenta-se com pápulas translúcidas, edematosas, tornando a pele com aspecto enrugado, após breve contato com água e a sua resolução ocorre após a secagem do local. Há associações com várias doenças, sendo a fibrose cística a mais destacada. Apresentamos um caso clínico peculiar da doença, com placa hipocrómica edematosa unilateral no calcanhar esquerdo, com boa resposta ao tratamento com vaselina salicilada a 3%.Aquagenic keratodermais a rare acquired disorder, most prevalent in young female patients, affecting mainly palmar and plantar regions. Clinically, it presents as translucent edematous papules that after a brief immersion in water turn into a wrinkling skin surface, and resolve after drying the affected region. There are associations with several diseases and Cystic Fibrosis is the most related. We report a peculiar clinical case of the disease, with unilateral edematous hypochromic plaque on left heel with good response to treatment with 3% salycilic acid in vaseline. There was no respiratory involvement

The Starch Is (Not) Just Another Brick in the Wall: The Primary Metabolism of Sugars During Banana Ripening

The monocot banana fruit is one of the most important crops worldwide. As a typical climacteric fruit, the harvest of commercial bananas usually occurs when the fruit is physiologically mature but unripe. The universal treatment of green bananas with ethylene or ethylene-releasing compounds in order to accelerate and standardize the ripening of a bunch of bananas mimics natural maturation after increasing the exogenous production of ethylene. The trigger of autocatalytic ethylene production regulated by a dual positive feedback loop circuit derived from a NAC gene and three MADS genes results in metabolic processes that induce changes in the primary metabolism of bananas. These changes include pulp softening and sweetening which are sensorial attributes that determine banana postharvest quality. During fruit development, bananas accumulate large amounts of starch (between 15 and 35% w/w of their fresh weight, depending on the cultivar). Pulp softening and sweetening during banana ripening are attributed not only to changes in the activities of cell wall hydrolases but also to starch-to-sugar metabolism. Therefore, starch granule erosion and disassembling are key events that lead bananas to reach their optimal postharvest quality. The knowledge of the mechanisms that regulate sugar primary metabolism during banana ripening is fundamental to reduce postharvest losses and improve final product quality, though. Recent studies have shown that ethylene-mediated regulation of starch-degrading enzymes at transcriptional and translational levels is crucial for sugar metabolism in banana ripening. Furthermore, the crosstalk between ethylene and other hormones including indole-3-acetic acid and abscisic acid also influences primary sugar metabolism. In this review, we will describe the state-of-the-art sugar primary metabolism in bananas and discuss the recent findings that shed light on the understanding of the molecular mechanisms involved in the regulation of this metabolism during fruit ripening

INFECÇÃO DO TRATO URINÁRIO EM PEDIATRIA: ABORDAGENS DIAGNÓSTICAS E TERAPÊUTICAS - UMA REVISÃO BIBLIOGRÁFICA DE LITERATURA

Introduction: Urinary tract infections (UTI), when not properly diagnosed and treated, can lead to short- and long-term complications, impacting not only current health, but also future kidney development. Objective: To analyze the diagnostic and therapeutic approaches to UTI in the pediatric age group. Methodology: This is a bibliographical review, using articles present in the following databases: PubMed, Scopus and SciELO. Original articles and systematic reviews in English and Portuguese published between 2014 and 2024 were included, which addressed diagnostic and therapeutic approaches to UTI in the pediatric age group. After analysis, 16 articles were selected to prepare this bibliographic review. Results and Discussion: The incorporation of complementary exams plays a crucial role in the diagnostic approach to UTI in pediatric patients, particularly given the atypical presentation of symptoms. The therapeutic approach generally includes administration of antibiotics, supportive care and, when necessary, further investigation to identify possible urinary tract abnormalities. Conclusion: Pediatric UTIs, although common, present diagnostic challenges due to often atypical symptoms and difficulty communicating in younger patients. Therefore, it is clear that early diagnosis and treatment are essential to ensure the health and well-being of affected children.Introducción: Las infecciones del tracto urinario (ITU), cuando no se diagnostican y tratan adecuadamente, pueden provocar complicaciones a corto y largo plazo, afectando no solo la salud actual, sino también el desarrollo renal futuro. Objetivo: Analizar los abordajes diagnóstico y terapéutico de la ITU en el grupo de edad pediátrica. Metodología: Se trata de una revisión bibliográfica, utilizando artículos presentes en las siguientes bases de datos: PubMed, Scopus y SciELO, se incluyeron artículos originales y revisiones sistemáticas en inglés y portugués publicados entre 2014 y 2024, que abordaron abordajes diagnósticos y terapéuticos de las ITU en pediatría. grupo de edad. Luego del análisis, se seleccionaron 16 artículos para elaborar esta revisión bibliográfica. Resultados y Discusión: La incorporación de exámenes complementarios juega un papel crucial en el abordaje diagnóstico de la ITU en pacientes pediátricos, particularmente dada la presentación atípica de los síntomas. El enfoque terapéutico generalmente incluye la administración de antibióticos, cuidados de apoyo y, cuando sea necesario, investigaciones adicionales para identificar posibles anomalías del tracto urinario. Conclusión: Las ITU pediátricas, aunque comunes, presentan desafíos diagnósticos debido a síntomas a menudo atípicos y dificultad de comunicación en pacientes más jóvenes. Por tanto, está claro que el diagnóstico y tratamiento tempranos son esenciales para garantizar la salud y el bienestar de los niños afectados.As infecções do trato urinário (ITU) quando não devidamente diagnosticadas e tratadas, podem acarretar complicações a curto e longo prazo, impactando não apenas a saúde atual, mas também o desenvolvimento renal futuro. Objetivo: Analisar as abordagens diagnósticas e terapêuticas da ITU na faixa etária pediátrica. Metodologia: Trata-se de uma revisão bibliográfica, utilizando artigos presentes nas seguintes bases de dados: PubMed, Scopus e SciELO Foram incluídos artigos originais e revisões sistemáticas em inglês e português publicadas entre 2014 e 2024, que abordassem sobre as abordagens diagnósticas e terapêuticas da ITU na faixa etária pediátrica. Após a análise, foram selecionados 16 artigos para a confecção dessa revisão bibliográfica.  Resultados e Discussão: A incorporação de exames complementares desempenha um papel crucial na abordagem diagnóstica da ITU em pacientes pediátricos, particularmente diante da apresentação atípica dos sintomas. A abordagem terapêutica geralmente inclui a administração de antibióticos, cuidados de suporte e, quando necessário, investigação adicional para identificar possíveis anomalias do trato urinário. Conclusão: As ITUs pediátricas, embora comuns, apresentam desafios diagnósticos devido à sintomatologia muitas vezes atípica e à dificuldade de comunicação em pacientes mais jovens. Dessa forma, é evidente que o diagnóstico e tratamento precoces são fundamentais para assegurar a saúde e bem-estar das crianças afetadas.Introdução: As infecções do trato urinário (ITU) quando não devidamente diagnosticadas e tratadas, podem acarretar complicações a curto e longo prazo, impactando não apenas a saúde atual, mas também o desenvolvimento renal futuro. Objetivo: Analisar as abordagens diagnósticas e terapêuticas da ITU na faixa etária pediátrica. Metodologia: Trata-se de uma revisão bibliográfica, utilizando artigos presentes nas seguintes bases de dados: PubMed, Scopus e SciELO Foram incluídos artigos originais e revisões sistemáticas em inglês e português publicadas entre 2014 e 2024, que abordassem sobre as abordagens diagnósticas e terapêuticas da ITU na faixa etária pediátrica. Após a análise, foram selecionados 16 artigos para a confecção dessa revisão bibliográfica.  Resultados e Discussão: A incorporação de exames complementares desempenha um papel crucial na abordagem diagnóstica da ITU em pacientes pediátricos, particularmente diante da apresentação atípica dos sintomas. A abordagem terapêutica geralmente inclui a administração de antibióticos, cuidados de suporte e, quando necessário, investigação adicional para identificar possíveis anomalias do trato urinário. Conclusão: As ITUs pediátricas, embora comuns, apresentam desafios diagnósticos devido à sintomatologia muitas vezes atípica e à dificuldade de comunicação em pacientes mais jovens. Dessa forma, é evidente que o diagnóstico e tratamento precoces são fundamentais para assegurar a saúde e bem-estar das crianças afetadas

COVID-19 outcomes in people living with HIV: Peering through the waves

Objective: To evaluate clinical characteristics and outcomes of COVID-19 patients infected with HIV, and to compare with a paired sample without HIV infection. Methods: This is a substudy of a Brazilian multicentric cohort that comprised two periods (2020 and 2021). Data was obtained through the retrospective review of medical records. Primary outcomes were admission to the intensive care unit, invasive mechanical ventilation, and death. Patients with HIV and controls were matched for age, sex, number of comorbidities, and hospital of origin using the technique of propensity score matching (up to 4:1). They were compared using the Chi-Square or Fisher's Exact tests for categorical variables and the Wilcoxon for numerical variables. Results: Throughout the study, 17,101 COVID-19 patients were hospitalized, and 130 (0.76%) of those were infected with HIV. The median age was 54 (IQR: 43.0;64.0) years in 2020 and 53 (IQR: 46.0;63.5) years in 2021, with a predominance of females in both periods. People Living with HIV (PLHIV) and their controls showed similar prevalence for admission to the ICU and invasive mechanical ventilation requirement in the two periods, with no significant differences. In 2020, in-hospital mortality was higher in the PLHIV compared to the controls (27.9% vs. 17.7%; p = 0.049), but there was no difference in mortality between groups in 2021 (25.0% vs. 25.1%; p > 0.999). Conclusions: Our results reiterate that PLHIV were at higher risk of COVID-19 mortality in the early stages of the pandemic, however, this finding did not sustain in 2021, when the mortality rate is similar to the control group

AÇÕES DE CUIDADO À DIABETES MELLITUS NA ESTRATÉGIA SAÚDE DA FAMÍLIA

Objective: To discuss the existing literature on diabetes mellitus care in the family health strategy. Methods: This is a qualitative integrative literature review. The search for the studies involved in the research was carried out in the following databases: SCIELO, LILACS, BDENF and MEDLINE, using the descriptors in health sciences: "Primary health care", "Diabetes mellitus" and "Health promotion". The inclusion criteria were: published between 2013 and 2023, with free access to full texts, articles in Portuguese, English and Spanish and related to the theme. Exclusion criteria were: duplicate articles, incomplete articles, abstracts, reviews, debates, articles published in event proceedings and unavailable in full. Results: The Ministry of Health recommends that anthropometric and BP measurements should be taken when patients with DM are cared for in primary care, as these are relevant data from the patient's physical examination about the pathology. Conclusion: The study in question shows that the FHS is the main point for caring for people with diabetes mellitus, because in basic health units, professionals have strategies aimed at promoting and preventing the health of these individuals.Objetivo:  Discutir por meio da literatura existente acerca das ações de cuidado à diabetes mellitus na estratégia saúde da família. Métodos: Trata-se de uma revisão integrativa da literatura de caráter qualitativo. A busca dos trabalhos envolvidos na pesquisa foi realizada nas seguintes bases de dados: SCIELO, LILACS, BDENF e MEDLINE, a partir dos descritores em ciências da saúde: “Atenção primária á saúde”, “Diabetes mellitus” e “Promoção da saúde”. Os critérios de inclusão foram: publicados no período entre 2013 e 2023, cujo acesso ao periódico era livre aos textos completos, artigos em idioma português, inglês e espanhol e relacionados a temática. Critérios de exclusão foram: artigos duplicados, incompletos, resumos, resenhas, debates, artigos publicados em anais de eventos e indisponíveis na íntegra. Resultados: O Ministério da Saúde preconiza que no atendimento aos pacientes com DM na atenção básica, sejam coletadas as medidas antropométricas e da PA, já que são dados relevantes do exame físico do paciente sobre a patologia. Conclusão: O estudo em questão demonstra que a ESF é o principal ponto para se realizar os cuidados as pessoas com Diabetes Mellitus, pois nas unidades básicas de saúde os profissionais se dispõem de estratégias que visa a promoção e prevenção da saúde desses indivíduos

SARS-CoV-2 uses CD4 to infect T helper lymphocytes

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the agent of a major global outbreak of respiratory tract disease known as Coronavirus Disease 2019 (COVID-19). SARS-CoV-2 infects mainly lungs and may cause several immune-related complications, such as lymphocytopenia and cytokine storm, which are associated with the severity of the disease and predict mortality. The mechanism by which SARS-CoV-2 infection may result in immune system dysfunction is still not fully understood. Here, we show that SARS-CoV-2 infects human CD4+ T helper cells, but not CD8+ T cells, and is present in blood and bronchoalveolar lavage T helper cells of severe COVID-19 patients. We demonstrated that SARS-CoV-2 spike glycoprotein (S) directly binds to the CD4 molecule, which in turn mediates the entry of SARS-CoV-2 in T helper cells. This leads to impaired CD4 T cell function and may cause cell death. SARS-CoV-2-infected T helper cells express higher levels of IL-10, which is associated with viral persistence and disease severity. Thus, CD4-mediated SARS-CoV-2 infection of T helper cells may contribute to a poor immune response in COVID-19 patients.</p

SARS-CoV-2 uses CD4 to infect T helper lymphocytes

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the agent of a major global outbreak of respiratory tract disease known as Coronavirus Disease 2019 (COVID-19). SARS-CoV-2 infects mainly lungs and may cause several immune-related complications, such as lymphocytopenia and cytokine storm, which are associated with the severity of the disease and predict mortality. The mechanism by which SARS-CoV-2 infection may result in immune system dysfunction is still not fully understood. Here, we show that SARS-CoV-2 infects human CD4+ T helper cells, but not CD8+ T cells, and is present in blood and bronchoalveolar lavage T helper cells of severe COVID-19 patients. We demonstrated that SARS-CoV-2 spike glycoprotein (S) directly binds to the CD4 molecule, which in turn mediates the entry of SARS-CoV-2 in T helper cells. This leads to impaired CD4 T cell function and may cause cell death. SARS-CoV-2-infected T helper cells express higher levels of IL-10, which is associated with viral persistence and disease severity. Thus, CD4-mediated SARS-CoV-2 infection of T helper cells may contribute to a poor immune response in COVID-19 patients.</p

Características epidemiológicas de pacientes com Sepse e choque séptico

A sepse ocorre quando o sistema imunitário reage radicalmente a uma infecção. Febre alta, dificuldade respiratória, ritmo cardíaco acelerado e confusão são os principais sintomas. Para a prevenção de complicações que põem em risco a vida, é fundamental a atenção médica imediata. Este estudo teve como objetivo identificar características epidemiológicas de pacientes com sepse e choque séptico. Para isso, foi realizada uma revisão integrativa de literatura, utilizando-se LILACS e Medline como bases de pesquisa. A partir da análise qualitativa dos dados, concluiu-se que os principais fatores epidemiológicos se referem ao diagnóstico de sepse, o qual pode ser de difícil execução, realizado com atraso, de modo incorreto ou superdiagnosticado, e a inobservância das recomendações (práticas de enfermagem) para os cuidados com a sepse. Esses fatores contribuem para o agravamento da sepse, o atendimento de pacientes em unidades de terapia intensiva e o aumento dos níveis de mortalidade