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The regulation of the hypothalamic-pituitary-adrenal (HPA) axis is associated with polymorphisms and the methylation degree of the glucocorticoid receptor gene (NR3C1) and is potentially involved in the development of metabolic syndrome (MetS). In order to evaluate the association between MetS with the polymorphisms, methylation, and gene expression of the NR3C1 in the genetically isolated Brazilian Mennonite population, we genotyped 20 NR3C1 polymorphisms in 74 affected (MetS) and 138 unaffected individuals without affected first-degree relatives (Co), using exome sequencing, as well as five variants from non-exonic regions, in 70 MetS and 166 Co, using mass spectrometry. The methylation levels of 11 1F CpG sites were quantified using pyrosequencing (66 MetS and 141 Co), and the NR3C1 expression was evaluated via RT-qPCR (14 MetS and 25 Co). Age, physical activity, and family environment during childhood were associated with MetS. Susceptibility to MetS, independent of these factors, was associated with homozygosity for rs10482605*C (OR = 4.74, pcorr = 0.024) and the haplotype containing TTCGTTGATT (rs3806855*T_ rs3806854*T_rs10482605*C_rs10482614*G_rs6188*T_rs258813*T_rs33944801*G_rs34176759*A_rs17209258*T_rs6196*T, OR = 4.74, pcorr = 0.048), as well as for the CCT haplotype (rs41423247*C_ rs6877893*C_rs258763*T), OR = 6.02, pcorr = 0.030), but not to the differences in methylation or gene expression. Thus, NR3C1 polymorphisms seem to modulate the susceptibility to MetS in Mennonites, independently of lifestyle and early childhood events, and their role seems to be unrelated to DNA methylation and gene expression.

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OBJECTIVE: Decades of research have highlighted the involvement of the prefrontal cortex, anterior cingulated cortex, and limbic areas (amygdala) in panic disorder (PD). However, little attention has been given specifically to the inferior frontal gyrus. The current study aimed to investigate the neural substrates, including the inferior frontal gyrus, of both panic-related and negative conditions among individuals with PD and healthy controls. METHODS: We examined 13 medication-free PD patients and 14 healthy controls with functional magnetic resonance imaging (fMRI) during exposure to negative and neutral pictures and a set of specific panic-related pictures. RESULTS: Subtraction between the conditions indicated activation of the left amygdala region and the right inferior frontal gyrus in PD patients during the specific panic-related condition, whereas the left amygdalar region and left inferior frontal gyrus were activated during the negative condition in controls. CONCLUSION: These results suggest that in patients with PD, a prominent bottom-up process is involved in specific panic-related conditions, which might be associated with weak modulation of the left frontal area. These data add to our current understanding of the neural correlates of PD and can contribute to future clinical interventions targeting the functional reestablishment of these regions.

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The Mennonite population suffered several bottlenecks due to religious/political persecution, increasing the frequency of diseases with a strong genetic component. We evaluated health self-perception in 430 Mennonites from South Brazilian settlements (two rural, one urban), along with life habits, xenobiotic exposure, and chronic ilnesses, using a modified version of the 2013 Brazilian National Health Survey and eight psychometric tests (applied in 2016-2018). Mennonites from rural settlements considered their health worse (P < 0.0001). This was independently associated with any psychiatric disease (OR 3.10, P = 0.037), depression diagnosis (OR 2.39, P = 0.002), spinal pain (OR 1.76, P = 0.015), waist circumference (OR 1.02, P = 0.009) and geographic origin (OR 0.64, P = 0.003). In the multivariate analysis including the scales, independent association also occurred with higher anxiety (ASI-R: OR 6.48, P = 0.014) and depression scores (BDI: OR 6.72, P = 0.008). Thus, a worse health self-perception was unequivocally associated with diagnosed or present depression/anxiety, independent of other contributors, suggesting a strong link between both.

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Chikungunya fever (CHIK) has caused important epidemic outbreaks in the Americas, with musculoskeletal involvement being the main manifestation, causing chronic symptoms in half of the affected patients. This study was performed to evaluate the clinical course of the infection in 168 patients with autoimmune inflammatory disease using biological disease-modifying antirheumatic drugs (bDMARDs), comparing this group with 56 household controls. Anti-CHIKV IgG serology was positive in 42 (25%) of the patients in the bDMARD group and in 15 (27%) of the controls (p=0.79). Of those with positive serology, 32 (76%) and 14 (93%) were symptomatic among subjects in the bDMARD and control groups, respectively (p=0.87). Persistence of musculoskeletal symptoms for more than three months occurred in 64% of the patients in the control group and only in 28% in the bDMARD group (p=0.021), maintaining a statistically significant difference only for users of anti-TNF. This study found that patients affected by chikungunya fever using bDMARDs did not present severe forms or complications in the acute phase of the disease, and patients using anti-TNF biologicals had a lower frequency of chronic joint symptoms than the household controls. This favorable outcome may be related to the cytokine blockade, with a reduction in the inflammatory response and joint damage.

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BACKGROUND: Stored grain insects are controlled with fumigant insecticides which can select resistant insect populations and cause environmental and applicator contamination. Thus, resistant cultivars and chemical constituents of essential oils are an alternative to the almost exclusive use of these insecticides. The effects of the combination of cowpea cultivars Vigna unguiculata (L.) Walp. with chemical constituents of essential oils against Callosobruchus maculatus were determined. Four cowpea cultivars: BRS Tracuateua, BR 17 Gurgueia, Epace 10 and Sempre Verde (insect rearing) untreated were used in the experiments and combined with chemical constituents of essential oil: eugenol, geraniol and trans-anethole. The biological parameters observed were: total egg number and eggs per grain, egg viability (%), insects emerged and insects per grain, immature stage viability (%), instantaneous rate of growth (ri), insect dry weight (mg), grain weight loss (%) and egg-adult period. RESULTS: When comparing all biological parameters, the cultivars BRS Tracuateua and BR 17 Gurgueia were harmful to C. maculatus. In the toxicity tests, the results showed that LC30 and LC50 of the chemical constituents ranged from 54.77 to 103.48 ppm and 60.99 to 125.18 ppm, respectively. In most of the biological parameters, LC50 had adverse effects significantly higher than LC30 and BR 17 Gurgueia treated were harmful to C. maculatus. CONCLUSIONS: Overall, the findings showed that BR 17 Gurgueia combined with eugenol and geraniol more significantly affected the biological parameters of C. maculatus than when associated with trans-anethole, reducing egg number, insects emerged and egg viability. © 2020 Society of Chemical Industry.

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The purpose of this study was to evaluate the monthly milk production and quality of buffaloes from two milk production systems in the Brazilian northeast using the multivariate analysis: principal component analysis (PCA). A total of 2,506 individual milk recordings were performed in two production systems, containing information on milk production (kg day-1), fat, protein, lactose and total solids counts and somatic cell count (SCC). There were positive correlations between the fat content and the contents of total solids (TS) and protein, and of TS and protein. From the PCA, two main components (PC1 and PC2) were identified, explaining 67.71% of the total variation. The fat, protein, lactose and ST level, represented by PC1, explain 46.18% of the total variance, and were an indicator of milk nutritional quality. The CP2, composed of milk production, SCC and production systems, explains 21.53% of the total variance, and was indicative of herd health. PCA results may be useful in dairy buffalo breeding programs, and a reduced number of variables are necessary to assess the nutritional quality of milk and herd health.

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The purpose of this study was to evaluate the monthly milk production and quality of buffaloes from two milk production systems in the Brazilian northeast using the multivariate analysis: principal component analysis (PCA). A total of 2,506 individual milk recordings were performed in two production systems, containing information on milk production (kg day-1), fat, protein, lactose and total solids counts and somatic cell count (SCC). There were positive correlations between the fat content and the contents of total solids (TS) and protein, and of TS and protein. From the PCA, two main components (PC1 and PC2) were identified, explaining 67.71% of the total variation. The fat, protein, lactose and ST level, represented by PC1, explain 46.18% of the total variance, and were an indicator of milk nutritional quality. The CP2, composed of milk production, SCC and production systems, explains 21.53% of the total variance, and was indicative of herd health. PCA results may be useful in dairy buffalo breeding programs, and a reduced number of variables are necessary to assess the nutritional quality of milk and herd health.(AU)

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A dermatite associada a incontinência (DAI) e lesão por pressão (LP) é dano que acomete a pele, principalmente de indivíduos hospitalizados em situações críticas. Esses eventos podem ter apresentação clínica semelhante, sendo fundamental que os profissionais de saúde saibam diferenciá-los. Este estudo visa avaliar o conhecimento da equipe de Enfermagem quanto à LP nos estágios 1 e 2 e da DAI em relação ao conceito, identificação, prevenção e tratamento. É pesquisa descritiva exploratória, transversal, com análise quantitativa, realizada com 76 profissionais de Enfermagem. Os dados foram coletados no mês de outubro de 2017 e foi realizada abordagem prévia com os profissionais para informá-los sobre a pesquisa e o questionário. O instrumento foi distribuído aos participantes durante o horário de trabalho, e estes o preencheram e retornaram aos pesquisadores. Foi aplicado questionário com questões sobre definição, avaliação e prevenção e tratamento da DAI e LP. O estudo revelou no teste de conhecimento que, entre as alterações cutâneas de DAI e LP, os acertos foram maiores naquelas questões sobre a DAI. Em relação à categoria avaliação, o índice de acertos foi próximo do médio (56,58%). Na categoria prevenção e tratamento, o maior percentual de acertos foi entre questões que envolviam a importância da capacitação dos profissionais e medidas de cuidados diretos ao paciente. Concluiu-se que, entre as afecções cutâneas DAI e LP nos estágios iniciais, os profissionais demonstraram menos conhecimento sobre a LP.(AU)

Incontinence-associated dermatitis (IAD) and pressure injury (PI) are problems that affect the skin, especially in the case of hospitalized individuals in critical situations. These events may have a similar clinical presentation and it is essential that health professionals know how to differentiate them. This study aims to evaluate the knowledge of the nursing team about PI in stages 1 and 2 and of IAD regarding the concept, identification, prevention and treatment. This is a descriptive, exploratory, cross-sectional study with quantitative analysis performed with 76 nursing professionals. The data were collected in October 2017 and professionals were first approached to pass on information about the research and the questionnaire. The instrument was distributed to participants during working hours, and they filled it out and returned it to the researchers. The questionnaire applied had questions on definition, evaluation, prevention and treatment of IAD and PI. The study revealed that, with respect to skin changes caused by IAD and PI, the correct answers were more frequent in questions about IAD. Regarding evaluation, the rate of correct answers was close to the average (56.58%). In the prevention and treatment category, the highest percentage of correct answers was found in questions that referred to the importance of professional qualification and direct care measures to patients. The study led to the...(AU)

La dermatitis asociada a la incontinencia (DAI) y lesión por presión (LP) afectan la piel, principalmente de pacientes hospitalizados en situación crítica. La presentación clínica de ambos trastornos es parecida y por ello es imprescindible que los profesionales de salud sepan distinguirlos. El presente estudio busca evaluar el conocimiento del equipo de enfermería en LP en las etapas 1 y 2 y en concepto, identificación, prevención y tratamiento de DAI. Investigación descriptiva, exploratoria, transversal con análisis cuantitativa, llevada a cabo con 76 profesionales de enfermería. La recogida de datos se realizó en octubre de 2017; antes se les informó a los profesionales sobre la investigación y el cuestionario. Durante el horario de trabajo, los participantes recibieron un cuestionario con preguntas sobre definición, evaluación, y prevención y tratamiento de DAI y LP, que completaron y devolvieron a los investigadores. A través de la prueba de conocimiento, el estudio reveló que, en los trastornos cutáneas de DAI y LP, había más respuestas correctas referentes a DAI. En la categoría evaluación, el índice de respuestas correctas fue equilibrado (56%). En prevención y tratamiento, el mayor porcentaje de respuestas correctas era sobre la importancia de la capacitación profesional y medidas de cuidados directos al paciente. Se concluye que, entre los trastornos de la piel DAI y LP en las primeras etapas, los profesionales demuestran tener menos conocimiento en LP.(AU)

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ABSTRACT CONTEXT: Today, through major technological advances in diagnostic resources within medicine, evaluation and monitoring of clinical parameters at the patient's bedside in intensive care units (ICUs) has become possible. CASE REPORT: This case report presents results and interpretations from predictive mechanical ventilation weaning indexes obtained through monitoring using chest electrical bioimpedance tomography. These indexes included maximum inspiratory pressure, maximum expiratory pressure, shallow breathing index and spontaneous breathing test. These were correlated with variations in tidal volume variables, respiratory rate, mean arterial pressure and peripheral oxygen saturation. Regarding the air distribution behavior in the pulmonary parenchyma, the patient showed the pendelluft phenomenon. Pendelluft occurs due to the time constant (product of the airways resistance and compliance) asymmetry between adjacent lung. CONCLUSION: Bioelectrical impedance tomography can help in weaning from mechanical ventilation, as in the case presented here. Pendelluft was defined as a limitation during the weaning tests.

RESUMO CONTEXTO: Atualmente, com o grande avanço tecnológico em recursos para diagnósticos em medicina, a avaliação e a monitorização de parâmetros clínicos à beira leito de paciente em unidade de terapia intensiva (UTI) se tornou possível. RELATO DE CASO: Neste relato de caso, apresentam-se os resultados e a interpretação de índices preditivos de desmame da ventilação mecânica obtidos pela tomografia de bioimpedância elétrica torácica. Esses índices incluíram a pressão inspiratória máxima, pressão expiratória máxima, índice de respiração superficial e teste de respiração espontânea. Estes estavam correlacionados com as variações de volume corrente, frequência respiratória, pressão arterial média e saturação periférica de oxigênio. Quanto ao comportamento da distribuição de ar no parênquima pulmonar, o paciente apresentou o fenômeno pendelluft. O pendelluft ocorre dado pela constante de tempo (produto da resistência e complacência das vias aéreas) de forma assimétrica entre as unidades pulmonares adjacentes. CONCLUSÃO: A tomografia de bioimpedância pode auxiliar no desmame da ventilação mecânica, como no caso apresentado. Pendelluft foi definido como limitação durante a execução dos testes para desmame.

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CONTEXT:: Today, through major technological advances in diagnostic resources within medicine, evaluation and monitoring of clinical parameters at the patient's bedside in intensive care units (ICUs) has become possible. CASE REPORT:: This case report presents results and interpretations from predictive mechanical ventilation weaning indexes obtained through monitoring using chest electrical bioimpedance tomography. These indexes included maximum inspiratory pressure, maximum expiratory pressure, shallow breathing index and spontaneous breathing test. These were correlated with variations in tidal volume variables, respiratory rate, mean arterial pressure and peripheral oxygen saturation. Regarding the air distribution behavior in the pulmonary parenchyma, the patient showed the pendelluft phenomenon. Pendelluft occurs due to the time constant (product of the airways resistance and compliance) asymmetry between adjacent lung. CONCLUSION:: Bioelectrical impedance tomography can help in weaning from mechanical ventilation, as in the case presented here. Pendelluft was defined as a limitation during the weaning tests.

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