ABSTRACT Background: Critical illness is a major ongoing health care burden worldwide and is associated with high mortality rates. Sodium-glucose cotransporter-2 inhibitors have consistently shown benefits in cardiovascular and renal outcomes. The effects of sodium-glucose cotransporter-2 inhibitors in acute illness have not been properly investigated. Methods: DEFENDER is an investigator-initiated, multicenter, randomized, open-label trial designed to evaluate the efficacy and safety of dapagliflozin in 500 adult participants with acute organ dysfunction who are hospitalized in the intensive care unit. Eligible participants will be randomized 1:1 to receive dapagliflozin 10mg plus standard of care for up to 14 days or standard of care alone. The primary outcome is a hierarchical composite of hospital mortality, initiation of kidney replacement therapy, and intensive care unit length of stay, up to 28 days. Safety will be strictly monitored throughout the study. Conclusion: DEFENDER is the first study designed to investigate the use of a sodium-glucose cotransporter-2 inhibitor in general intensive care unit patients with acute organ dysfunction. It will provide relevant information on the use of drugs of this promising class in critically ill patients. ClinicalTrials.gov registry: NCT05558098

RESUMO Antecedentes: A doença crítica é um importante ônus permanente da assistência médica em todo o mundo e está associada a altas taxas de mortalidade. Os inibidores do cotransportador de sódio-glicose do tipo 2 têm demonstrado consistentemente benefícios nos desfechos cardiovasculares e renais. Os efeitos dos inibidores do cotransportador de sódio-glicose do tipo 2 em doenças agudas ainda não foram devidamente investigados. Métodos: O DEFENDER é um estudo de iniciativa do investigador, multicêntrico, randomizado, aberto, desenhado para avaliar a eficácia e a segurança da dapagliflozina em 500 participantes adultos com disfunção orgânica aguda hospitalizados na unidade de terapia intensiva. Os participantes aptos serão randomizados 1:1 para receber 10mg de dapagliflozina e o tratamento padrão por até 14 dias ou apenas o tratamento padrão. O desfecho primário é um composto hierárquico de mortalidade hospitalar, início de terapia renal substitutiva e tempo de internação na unidade de terapia intensiva, até 28 dias. O monitoramento da segurança será rigoroso durante todo o estudo. Conclusão: O DEFENDER é o primeiro estudo desenvolvido para investigar o uso de um inibidor do cotransportador de sódio-glicose do tipo 2 em pacientes de unidade de terapia intensiva geral com disfunção orgânica aguda. O estudo fornecerá informações relevantes sobre o uso de medicamentos dessa classe promissora em pacientes críticos. Registro ClincalTrials.gov: NCT05558098

ABSTRACT Garden pansy is a versatile gardening plant – it produces beautiful colorful edible-flowers with high value in gourmet cuisine. The use of irrigation and biotechnology in garden pansy cultivation can provide gains in flower productivity and nutritional value. The goal of this study was to evaluate the growth and edible flower production in garden pansy plants, submitted to different levels of irrigation and mycorrhizal inoculation. The experiment was conducted in randomized blocks in the 2 x 5 factorial design, with the presence and absence of mycorrhizal inoculation in combination with 5 levels of irrigation with 6 replicates, in a greenhouse. There was no significant interaction between the factors mycorrhizal inoculation and irrigation levels by the F test. Under the tested conditions, the mycorrhizal inoculation was unable to provide significant changes in the growth, development and flowering of garden pansy plants. It was concluded that no symbiotic efficiency was pointed out between the mycorrhizal fungus used and garden pansy plants. The best growth and yield results for cultivating and producing edible flowers of garden pansy were obtained at the 100% replenishment level of water evaporation.

RESUMO Objetivo Analisar a percepção de alunos dos cursos de Fonoaudiologia e de Pedagogia a respeito de suas experiências e práticas de leitura e escrita de textos pertencentes ao gênero do discurso na esfera acadêmica. Método Pesquisa de caráter quanti-qualitativo, de corte transversal e do tipo analítico. Para o levantamento dos dados, foi aplicado um questionário com perguntas que abrangiam a relação dos alunos com a leitura e com a escrita de textos pertencentes ao gênero acadêmico e as dificuldades enfrentadas no uso desse gênero do discurso. Resultados Muitos alunos supõem que apresentam alguma dificuldade no uso dos gêneros discursivos usados na universidade, o que pode indicar lacunas no trabalho com a linguagem escrita nos níveis de ensino que antecederam sua entrada no Ensino Superior. Alguns discentes referiram que se sentem culpados por não acompanharem, de forma efetiva, as atividades de leitura e de escrita propostas em seus respectivos cursos universitários, subentendendo que isso se deve a um distúrbio inerente aos mesmos. Conclusão Apesar do aumento do número de alunos no Ensino Superior, muitos ainda sentem-se excluídos da vida acadêmica, especialmente, por não usarem, de maneira proficiente, textos próprios deste nível de ensino. Cabe à Universidade e a todos os atores envolvidos na formação superior promoverem ações que considerem o direito a educação de todos os alunos.

ABSTRACT Purpose to analyze the perception of Speech-Therapy and Education undergraduates regarding their experiences and practices in reading and writing texts from academic discourse genres. Methods It´s a mixed crosscut study, with data collected by the application of a semi-structured questionnaire with open and closed questions about students’ relation towards reading and writing of academic texts, their difficulties in the use of these genres and how they cope with such difficulties. Results The results show that a significant number of the students assume that they have some difficulty in reading and writing these discourse genres in academic settings, which may be an indication of gaps in working with reading and writing during previous educational levels. Some of these students even blame themselves for not effectively following the reading and writing proposals in higher education, implying that this is due to an intrinsic disorder. Conclusion The data allow us to state that, despite the increase in the number of students in higher education, many still feel excluded from academic life, especially for not using academic discourse genres in a proficient way. It is the University responsibility, along with all actors involved in higher education, to promote actions that consider the right to education for all students.

Abstract Background Studies on the prevalence of rare visceral aneurysms are still scarce and the few studies that have focused on these aneurysms present prevalence rates in groups of patients with visceral aneurysms, but little is known about their prevalence in the general population. Objectives To assess the prevalence of rare visceral aneurysms on CAT scans performed for diagnosis and follow-up of patients with other vascular pathologies. Methods This cross-sectional study began by accessing all reports from CAT scans performed between January 2005 and July 2021 at a private hospital of excellence located in the city of São Paulo. A software program for pre-indexed reports was used to search the Radiological Information System (RIS) database to identify reports of patients with intra-abdominal aneurysms. Results CAT scan reports from 92,883 patients were accessed. Of these, 2,597 (2.795%) showed intra-abdominal aneurysms, 937 (1.063%) of which were visceral, including 158 (0.171%) rare visceral aneurysms, which were more frequent among male patients and in the following segments: celiac trunk (0.098%), superior mesenteric (0.033%), left gastric (0.010%), pancreatic-duodenal (0.009%), and gastroduodenal arteries (0.005%) and the pancreatic arch (0.004%). Lower prevalence was found in other segments. Additional findings revealed concomitance of rare visceral aneurysms with other intra-abdominal aneurysms ranging from 11.11% to 66.67%. Conclusions The prevalence of rare visceral aneurysms in a large population undergoing CAT scan was 0.171%, with greater involvement in male patients.

Resumo Contexto Ainda são incomuns os estudos de prevalência de aneurismas viscerais raros, e os poucos estudos que focalizaram esses aneurismas observam taxas de prevalência em grupos de pacientes com aneurismas viscerais, mas pouco se conhece sobre a sua prevalência na população geral. Objetivos Avaliar a prevalência de aneurismas viscerais raros em angiotomografias realizadas para diagnóstico e seguimento de pacientes com diferentes patologias vasculares. Métodos Este estudo transversal partiu do acesso a todos os laudos de angiotomografias realizadas entre janeiro de 2005 e julho de 2021 em hospital privado de excelência situado na cidade de São Paulo. Foi utilizado um programa de mecanismo de busca de laudos pré-indexados, cuja base de dados é o Sistema de Informação Radiológica (RIS), para acesso aos laudos de pacientes com aneurismas intra-abdominais. Resultados Foram acessados laudos de angiotomografias de 92.883 pacientes, dos quais 2.597 (2,795%) apresentavam aneurismas intra-abdominais, sendo 937 (1,063%) viscerais, incluindo 158 (0,171%) aneurismas viscerais raros, mais frequente entre homens e nos seguintes segmentos: tronco celíaco (0,098%), artéria mesentérica superior (0,033%), artéria gástrica esquerda (0,010%), artéria pancreático-duodenal (0,009%), artéria gastroduodenal (0,005%) e arco pancreático (0,004%). Prevalências menores foram encontradas em outros diferentes segmentos. Achados adicionais revelaram taxa de concomitância de aneurismas viscerais raros com outros aneurismas intra-abdominais entre 11,11% e 66,67%. Conclusões A prevalência de aneurismas viscerais raros em ampla população submetida a angiotomografias foi de 0,171%, com maior comprometimento nos pacientes do sexo masculino.

Abstract Background Socioeconomic status has been linked to ischemic heart disease (IHD). High-income neighborhoods may expose individuals to a walking-promoting built environment for daily activities (walkability). Data from the association between income and IHD is lacking in middle-income countries. It is also uncertain whether walkability mediates this association. Objectives To investigate whether income is associated with IHD in a middle-income country and whether neighborhood walkability mediates the income-IHD association. Methods This cross-sectional study evaluated 44,589 patients referred for myocardial perfusion imaging (SPECT-MPI). Income and walkability were derived from participants’ residential census tract. Walkability quantitative score combined 4 variables: street connectivity, residential density, commercial density, and mixed land use. IHD was defined by abnormal myocardial perfusion during a SPECT-MPI study. We used adjusted mixed effects models to evaluate the association between income level and IHD, and we performed a mediation analysis to measure the percentage of the income-IHD association mediated by walkability. We considered p values below 0.01 as statistically significant. Results From 26,415 participants, those living in the lowest-income tertile census tract were more physically inactive (79.1% versus 75.8% versus 72.7%) when compared to higher-income tertile census tracts (p < 0.001). Income was associated with IHD (odds ratio: 0.91 [95% confidence interval: 0.87 to 0.96] for each 1,000.00 international dollars increase in income) for both men and women equally (p for interaction = 0.47). Census tracts with a higher income were associated with better walkability (p < 0.001); however, walkability did not mediate the income-IHD association (percent mediated = −0.3%). Conclusions Income was independently associated with higher prevalence of IHD in a middle-income country irrespective of gender. Although walkability was associated with census tract income, it did not mediate the income-IHD association.

Resumo Fundamento O nível socioeconômico tem sido associado à doença isquêmica do coração (DIC). Bairros de alta renda podem expor os indivíduos a um ambiente construído que promova caminhadas para atividades diárias (caminhabilidade). Faltam dados sobre a associação entre renda e DIC em países de renda média. Também é incerto se a caminhabilidade medeia essa associação. Objetivos Investigar se a renda está associada à DIC em um país de renda média e se a caminhabilidade dos bairros medeia a associação entre renda e DIC. Métodos O presente estudo transversal avaliou 44.589 pacientes encaminhados para imagem de perfusão miocárdica (SPECT-MPI). A renda e a caminhabilidade foram derivadas do setor censitário residencial dos participantes. A pontuação quantitativa da caminhabilidade combinou as seguintes 4 variáveis: conectividade viária, densidade residencial, densidade comercial e uso misto do solo. A DIC foi definida pela presença de perfusão miocárdica anormal durante um estudo SPECT-MPI. Utilizamos modelos ajustados com efeitos mistos para avaliar a associação entre nível de renda e DIC e realizamos uma análise de mediação para medir o percentual da associação entre renda e DIC mediada pela caminhabilidade. Consideramos valores de p abaixo de 0,01 como estatisticamente significativos. Resultados Dos 26.415 participantes, aqueles que residiam no setor censitário do tercil de menor renda eram mais fisicamente inativos (79,1% versus 75,8% versus 72,7%) quando comparados aos setores censitários do tercil de maior renda (p < 0,001). A renda foi associada à DIC (odds ratio: 0,91 [intervalo de confiança de 95%: 0,87 a 0,96] para cada aumento de 1000,00 dólares internacionais na renda), para homens e mulheres igualmente (p para interação = 0,47). Os setores censitários com maior renda estiveram associados a uma melhor caminhabilidade (p < 0,001); no entanto, a caminhabilidade não mediou a associação entre renda e DIC (porcentagem mediada = −0,3%). Conclusões A renda foi independentemente associada a maior prevalência de DIC em um país de renda média, independentemente de gênero. Embora a caminhabilidade tenha sido associada à renda do setor censitário, ela não mediou a associação entre renda e DIC.

Abstract Introduction Streptococcus gallolyticus belongs to theStreptococcus bovis complex, and it is a common bacterium colonizing the gastrointestinal tract. Its presence in the blood may suggest an underlying pathology such as a colonic neoplasm. We report herein a case of S. bovis bacteremia in an apheresis platelet donor, review similar cases in the literature, and suggest a flowchart for the management of similar cases in other blood donation centers. Case Presentation A 61-year-old subject presented to a Hemotherapy Service to make an apheresis platelet donation. On quality control testing, S. gallolyticus was identified in hemoculture, and the donor was called back for follow-up. At first, a new hemoculture was requested, and the patient was referred to the outpatient department of infectious diseases to further investigate pathologies associated with S. gallolyticus. A subsequent colonoscopy investigation evidenced a polypoid structure in the ascending colon. Pathology reported the resected specimen as a low-grade tubular adenoma. Conclusion Isolation of S. bovis in blood products requires further investigation and should be managed with precision by Hemotherapy Services. A standard protocol for the management of asymptomatic patients with S. bovis positive hemoculture, with the requests of a new blood culture, a colonoscopy, and an echocardiogram is crucial, as it may ensure early diagnosis and reduce morbidity and mortality.

RESUMEN Objetivo. El objetivo fue evaluar el efecto de la variabilidad de las lluvias sobre la composición química, la degradabilidad in vitro y la producción de gas de cactus en la región Semiárida. Materiales y métodos. Este fue un diseño experimental completamente al azar en un arreglo factorial de 2 períodos de lluvia (lluvia alta y baja) x 5 especies de cactus, con 5 repeticiones. Los cactus evaluados fueron Pilosocereus gounellei (Weber ex K. Schum). Bly ex Rowl, Cereus jamacaru DC., Opuntia ficus indica Mill, Nopalea cochenillifera Salm. Dyck y Opuntia stricta (Haw.) Haw, todas frescas. Resultados. Hubo una interacción entre la variación de la lluvia y las especies de cactus para materia seca, proteína cruda, fibra detergente neutra y fibra detergente ácido (p<0.05), producción de gas in vitro (p<0.05) y para la degradabilidad in vitro de materia seca (p<0.05). Entre los cactus, Pilosocereus gounellei presentó una menor proporción de materia orgánica y un aumento en el contenido de materia mineral en relación a los demás cactus (p<0.05). Conclusiones. La composición química, los coeficientes de producción de gas y la degradabilidad in vitro fueron influenciados por las especies de cactus y por la variación de las precipitaciones. Las especies de cactus aumentan el contenido de materia seca, proteína cruda y fibra de detergente neutro durante la escasez de precipitaciones. Las variedades de nopal (Opuntia y Nopalea) se destacaron entre los cactus ensayados en relación a la producción de gas y la degradabilidad in vitro.

ABSTRACT Objective. The objective was to evaluate the effect of rainfall variability on the chemical composition, in vitro degradability and gas production of cacti in Semiarid region. Materials and methods. A completely randomized experimental design in a factorial arrangement of 2 rainfall periods (high and low rainfall) x 5 cactus species, with 5 replications was adopted. Cacti evaluated were Pilosocereus gounellei (Weber ex K. Schum). Bly ex Rowl, Cereus jamacaru DC., Opuntia ficus indica Mill, Nopalea cochenillifera Salm. Dyckand Opuntia stricta (Haw.) Haw, all fresh. Results. There was an interaction between rainfall variation and cactus species for dry matter, crude protein, neutral detergent fiber and acid detergent fiber (p<0.05), in vitro gas production (p<0.05) and for in vitro dry matter degradability (p<0.05). Among cacti, Pilosocereus gounellei presented a lower proportion of organic matter and an increase in the content of mineral matter in relation to the other cacti (p<0.05). Conclusions. The chemical composition, the gas production coefficients and the in vitro degradability were influenced by the cacti species and by the rainfall variation. Cacti species increase the dry matter, crude protein and neutral detergent fiber contents during the low rainfall. Varieties of cactus pear (Opuntia and Nopalea) stood out among the cacti tested in relation to gas production and in vitro degradability.

RESUMO: Testes in vitro são realizados para avaliar a eficácia de aditivos antimicotoxinas (AAMs); entretanto, tais experimentos apresentam uma baixa correlação com ensaios in vivo, que também são exigidos para determinar a eficácia de AAMs. Em busca de um método alternativo, o presente estudo investigou o uso de uma técnica ex vivo. A capacidade de seis AAMs (AAM1 a AAM6) de reduzir a absorção intestinal de aflatoxina B1 (AFB1) foi avaliada. Explantes jejunais foram coletados de frangos de corte e submetidos a dois tratamentos por AAM em câmaras de Ussing: T1 (controle) - 2,8 mg/L AFB1, e T2 - 2.8 mg/L AFB1 + 0,5% AAM. Os AAMs também foram testados in vitro para verificar a adsorção de AFB1 em fluido intestinal artificial. Nos ensaios ex vivo, AAM1 ao AAM6 diminuíram a absorção intestinal de AFB1 em 67,11%, 73,82%, 80,70%, 85,86%, 86,28% e 82,32%, respectivamente. Quanto aos achados in vitro, AAM1 ao AAM6 apresentaram adsorção de 99,72%, 99,37%, 99,67%, 99,53%, 99,04% e 99,15%, respectivamente. O modelo ex vivo avaliado mostrou-se eficiente na avaliação de AAMs. Não houve correlação entre os resultados ex vivo e in vitro. Estudos adicionais são necessários para definir a correlação entre achados ex vivo e in vivo na tentativa de reduzir os testes em animais.

ABSTRACT: In vitro tests are performed to evaluate the efficacy of antimycotoxins additives (AMAs); nevertheless, such assays show a low correlation with in vivo trials, which are also required to determine AMAs’ efficacy. In search of an alternative method, the current study investigated the use of an ex vivo technique. Six AMAs (AMA1 to AMA6) had their ability to reduce intestinal absorption of aflatoxin B1 (AFB1) evaluated. Jejunal explants were obtained from broilers and subjected to two treatments per AMA in Ussing chambers: T1 (control) - 2.8 mg/L AFB1, and T2 - 2.8 mg/L AFB1 + 0.5% AMA. AMAs were also tested in vitro to assess adsorption of AFB1 in artificial intestinal fluid. In the ex vivo studies, AMA1 to AMA6 decreased intestinal absorption of AFB1 by 67.11%, 73.82%, 80.70%, 85.86%, 86.28% and 82.32%, respectively. As for the in vitro results, AMA1 to AMA6 presented an adsorption of 99.72%, 99.37%, 99.67%, 99.53%, 99.04% and 99.15%, respectively. The evaluated ex vivo model proved useful in the assessment of AMAs. No correlation was reported between ex vivo and in vitro findings. Further studies are needed to elucidate the correlation between ex vivo and in vivo results seeking to reduce animal testing.

Abstract Lower lip squamous cell carcinomas (LLSCC) could be associated with a previous history of potentially malignant oral diseases (PMOD), especially actinic cheilitis (AC), with high sun exposure being a well-described risk factor. Immune evasion mechanisms, such as the PD-1/PD-L1 (programmed cell death protein 1/programmed death-ligand 1) pathway has been gaining prominence since immunotherapy with immune checkpoint inhibitors showed a positive effect on the survival of patients with different types of neoplasms. Concomitant with the characterization of the tumor microenvironment, the expression of either or both PD-1 and PD-L1 molecules may estimate mutual relations of progression or regression of the carcinoma and prognostic values of the patient. Objective: Considering the importance of tumor microenvironment characterization, this study aims to determine the immunoexpression of PD-L1 and correlate with the frequency of CD4+ and CD8+ cells in AC and LLSCC lesions and with tumor-infiltrating lymphocytes (TILs) in LLSCC and its relationship with histopathological characteristics. Methodology: This sample includes 33 cases of AC and 17 cases of LLSCC. The cases were submitted to histopathological analysis and to CD4+, CD8+, and PD-L1+ cell determination by immunohistochemistry. Results: There was a significant difference among the frequencies of CD4+, CD8+, and PD-L1+ cells between AC and LSCC cases, higher in the last group. Moreover, histopathological and atypical changes in AC and LLSCC were correlated with the frequencies of PD-L1+, CD4+, and CD8+ cells. In AC, PD-L1+ cases had a low frequency of CD4+ cells, but on the other hand, PD-L1+ cases of LLSCC had a higher frequency of CD4+ and CD8+ cells. Conclusion: Therefore, the PD-L1 molecule may be a potential escape route for the immune response in oral lesions, but the mechanisms differ between AC and LLSCC. Future studies related to immune evasion and immunotherapy in oral lesions should consider the analysis of inflammatory infiltrate and TILs.

Abstract The objective of this study was to prepare three donkey milk yoghurt formulations mixed with goat, cow and buffalo milk. The formulations were developed with 50% donkey milk and 50% cow, buffalo or goat milk. Concentrated mango pulp was added for flavouring. An evaluation was performed on the chemical composition of each milk sample and the formulated yoghurts. The donkey milk showed the lowest values for fat, protein, casein, total solids and non-fat solids. In turn, goat milk reached higher levels of fat and total solids. Furthermore, buffalo milk stood out with the highest values of protein and non-fat solids. Yoghurt made with donkey and buffalo milk showed higher concentrations of protein, lactose, total solids and non-fat solids. In contrast, the yoghurt that contained donkey and cow milk in its formulation obtained a higher fat percentage and a lower percentage of lactose, total solids and non-fat solids. The low content of fat and total solids in donkey milk, in addition to the structure of the casein micelles and small fat globules favor low consistency in fermented products. Thus, mixing donkey milk with milks from other animal species can result in better chemical composition and better consistency.

Abstract Chronic Lymphocytic Leukemia (CLL) has shown great biological heterogeneity, with a variable prognosis, and a short survival in some patients. In this light, the present study focused on the prognostic utility of circulating microparticles (MPs) and a Thrombin Generation (TG) Profile for thrombotic risk and disease progression in CLL patients. Circulating microparticles and TG were evaluated in 35 patients with CLL and 35 healthy individuals. For circulating microparticles, significant differences were observed among the following groups: MPs derived from endothelial cells (p = 0.002), B lymphocytes (p < 0.001), platelets (p = 0.003), and Tissue Factor MPs in monocytes (p < 0.001). In all cases, MP values were higher for the CLL group. When compared to the controls, CLL patients presented a decrease in TG, characterized by a reduced endogen thrombin potential (ETP) (p = 0.031). When the results were analyzed according to the Binet stage, as compared to the controls, the Binet B+C group also presented lower ETP values (p = 0.009). No significant differences were observed between the control and the Binet A groups or between the Binet A and the Binet B + C groups. Although hemostatic alterations may occur in patients with CLL, these parameters do not seem to be useful to indicate disease progression.

Abstract This study aimed to develop Greek style yoghurts with the addition of bovine colostrum. Four yoghurt formulations were produced with different colostrum content (0%, 10%, 20% and 30%). The fat, protein, total solids, ash, retinol levels were quantified as well as the colour was measured. A sensory analysis was conducted with 103 untrained panelists, evaluating the attributes of appearance, aroma, consistency, flavour, overall acceptance and the purchase intention. Colostrum addition increased the fat and protein levels in the yoghurt formulations. The Greek style yoghurts with bovine colostrum reached sensory acceptance above 70% for all attributes.

Abstract Chronic lymphocytic leukemia (CLL) is a blood cancer characterized by the accumulation of clonal B-lymphocytes. This study evaluated the mRNA gene expression of miR-15a, miR-16- 1, ZAP-70, and Ang-2 by qPCR, as well as the plasma levels of Bcl-2 by Elisa immunoassay, in CLL patients and healthy controls. Significant differences were observed when comparing patients and controls regarding miR-15a (p < 0.001), miR-16-1 (p < 0.001) mRNA, Ang-2 gene expression, and Bcl-2 plasma levels (p < 0.001). When stratified by risk, differences were maintained with a significantly reduced expression in high-risk patients. A positive correlation was observed between miR-15a and platelets (R2 = 0.340; p = 0.009) as well as between Bcl-2 and leukocytes (R2 = 0.310; p = 0.019). Conversely, negative correlations were observed between ZAP-70 and platelets (R2 = - 0.334; p = 0.011), between miR-15a and lymphocytes (R2 = - 0.376; p = 0.004), as well as between miR-16-and lymphocytes (R2 = - 0.515; p = 0.00004). The data suggest that a reduction in miR-15a and miR-16-1 expressions, in addition to an overexpression of Bcl-2, are associated with the reduction in apoptosis and, consequently, to a longer survival of lymphocytes, thus contributing to lymphocyte accumulation and aggravation of the disease. By contrast, Ang-2 expression was significantly higher in A than in B + C Binet groups. This context leads to the speculation that this biomarker should be investigated in more robust studies within populations with a still relevantly indolent form of the disease in an attempt to identify those patients with a greater potential for an aggravation of the disease.

Abstract The present study evaluated 56 patients diagnosed with Chronic Lymphocytic Leukemia (CLL) and a control group of 44 clinically healthy subjects with no previous history of leukemia. Genetic expressions of AKT and microRNAs were evaluated by quantitative PCR (qPCR). A significant increase in AKT gene expression in patients when compared to controls was observed (p = 0.017). When the patients were stratified according to Binet subgroups, a significant difference was observed between the subgroups, with this protein kinase appearing more expressed in the B+C subgroup (p = 0.013). Regarding miRNA expression, miR-let-7b and miR-26a were reduced in CLL patients, when compared to controls. However, no significant differences were observed in these microRNA expressions between the Binet subgroups (A versus B+C). By contrast, miR-21 to miR-27a oncogenes showed no expression difference between CLL patients and controls. AKT protein kinase is involved in the signaling cascade that occurs with BCR receptor activation, leading to increased lymphocyte survival and protection against the induction of cell death in CLL. Thus, increased AKT protein kinase expression and the reduction of miR-let-7b and miR-26a, both tumor suppressors, may explain increased lymphocyte survival in CLL patients and may be promising markers for the prognostic evaluation of this disease.

SUMMARY OBJECTIVE: This study aimed to compare the effects of therapeutic ultrasound and paraffin with or without vacuum massage on the biomechanical properties of grafted skin after a burn. METHODS: A total of 44 patients with deep second- and third-degree burns, with a mean age of 35.89 (±11.53) years, who visited the Hospital Burn Unity, were included in the study. The therapeutic interventions were randomly defined by drawing lots, with a crossover design (crossover), and a minimum interval of 7 days (washout) between interventions. Skin biomechanical parameters such as distensibility (R0) and viscoelasticity (R6) were noninvasively evaluated by Cutometer before and after 0, 10, 20, and 30 min of intervention with therapeutic ultrasound and paraffin alone, as well as associated with negative pressure therapy of the skin (vacuum therapy). In this study, all groups showed increased distensibility (R0) in the period immediately after the application of the resources and a progressive reduction in the effects in the consecutive tests. Participants with skin grafts showed a decrease in viscoelasticity (R6) in all groups, except therapeutic paraffin and therapeutic ultrasound and vacuum massage. CONCLUSION: The biomechanical properties of grafted skin after a burn are altered after therapeutic intervention with ultrasound alone or associated with vacuum massage, such as intervention with paraffin associated with vacuum massage, for both parameters evaluated, skin distensibility (R0) and skin viscoelasticity (R6). However, the same did not occur for the intervention with isolated paraffin. There was no significant difference between the interventions therapeutic ultrasound and therapeutic paraffin.